Retiree Drug Plans

2023 Plans for Retired BlueCross Employees 

BlueCross BlueShield of South Carolina offers retirees BlueSM Retiree Drug Plans. These group retiree drug plans are also referred to as Medicare Part D. Save on the drugs you need at network pharmacies nationwide and in South Carolina.

You are eligible to join one of the Blue Retiree Drug Plans if you are entitled to Medicare Part A and/or enrolled in Medicare Part B, are a retiree or spouse of a retiree, and are 65 years of age or older.

Compare Your Options

Blue Retiree Rx Essential (PDP)Blue Retiree Rx (PDP)Blue Retiree Rx Plus (PDP)
$30.00 monthly premium$74.00 monthly premium$187.00 monthly premium
Affordable copaymentsAffordable copaymentsNo deductible | Affordable copayments
Lower copayments at preferred network pharmaciesLower copayments at preferred network pharmaciesLower copayments at preferred network pharmacies | Low-cost generic drugs in the Coverage Gap
Cost-saving mail-order optionCost-saving mail-order optionCost-saving mail-order option

 

Frequently Asked Questions

 

Where can I get my prescriptions? 

BlueCross BlueShield of South Carolina has formed a network of pharmacies that you must use to receive Blue Retiree Rx plan benefits. In general, you must use network pharmacies to access your prescription drug benefit, except in special circumstances. The pharmacy network may change at any time. You will receive notice when necessary. For an up-to-date list of the pharmacies in our network, see our Pharmacy Directory, or search by pharmacy name or location using the Pharmacy Locator (this link leads to a third-party website).

How can I compare my options?

You can compare Blue Retiree Rx to other plans using our Summary of Benefits. Please note the Summary of Benefits doesn't list every service that we cover, or list every limitation or exclusion. To get a complete list of our benefits, please review the 2022 Blue Retire Rx Annual Notice of Changes or 2022 Blue Retiree Rx Plus Annual Notice of Changes as well as 2022 Blue Retiree Rx Essential Evidence of Coverage, 2022 Blue Retiree Rx Evidence of Coverage or 2022 Blue Retiree Rx Plus  Evidence of Coverage.

Am I eligible for subsidized coverage?

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:

  • 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/seven days a week.
  • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.
  • Your state Medicaid Office.

Learn more about the Medicare Extra Help program. This program provides additional help for people with limited income. You can also view the Centers for Medicare and Medicaid Services' (CMS) Best Available Evidence (BAE) policy.

What prescriptions are covered?

Blue Retiree Rx uses a prescription drug list. The formulary may change at any time. You will receive notice when necessary. We may occasionally make changes to the list. For the most current information, see our 2023 Retiree RX Essential Comprehensive Formulary, 2023 Blue Retiree Rx Comprehensive Formulary or 2023 Blue Retiree RX Plus Comprehensive Formulary or our 2023 Blue Retiree Rx Essential Drug Look-Up Tool and 2023 Blue Retiree Rx/Rx Plus Drug Look-Up Tool (these links lead to a third-party website). Restrictions may apply. For a list of upcoming changes, see the Formulary Change Notice.

Do some drugs have additional requirements or coverage limits?

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include Prior Authorization, Quantity Limits or Step Therapy. Links to our plan's Prior Authorization and Step Therapy criteria are below.

  • Prior Authorization: Requires you or your physician to get prior authorization for certain drugs. This means you will need to get approval before you fill your prescriptions. If you don’t get approval, the plan may not cover the drug.
  • Quantity Limits: For certain drugs, the plan limits the amount of the drug that will be covered.
  • Step Therapy: In some cases, the plan requires you to first try certain drugs to treat your medical condition before another drug will be covered for that condition. Quantity Limits: For certain drugs, the plan limits the amount of the drug that will be covered.

To see if your prescription drug has any additional requirements or limits on coverage, refer to the most current Comprehensive Formulary.

What's the Medication Therapy Management program?

The MTM program is a free service for eligible members of our plan and is not considered a benefit. This program is designed to help members keep their medications on the right track. MTM is a program offered by CVS/Caremark. CVS/Caremark is an independent company that offers pharmacy benefit management services on behalf of BlueCross. The purpose of the program is to:

  • Make sure all your medications are the right choice for your medical conditions
  • Teach you how to get the most from your medications
  • Lower your risk for potential harmful drug reactions and side effects
  • Teach you why it's important to take your medications on time
  • Help you potentially find ways to save money

 

It's easy to get started in the MTM program. If you are eligible, you are automatically enrolled, and you will receive a letter in the mail inviting you to participate. There is no added cost for participating, and you may decline individual services or opt-out of the program at any time. Learn more about the MTM Program.

Enroll Now

You can call one of our plan specialists toll free at 1-844-914-1251 (TTY 711) 8 a.m. to 8 p.m., Monday through Friday. From Oct. 1 to Mar. 31, our hours are 8 a.m. to 8 p.m., seven days a week.

If you prefer, you can download and print the enrollment form. Please send your completed enrollment form to: Medicare Advantage Marketing, P.O. Box 100206, Columbia, SC 29223-3206. 

Download the Form

Disclaimer

Last Updated: September 29, 2023

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BlueCross BlueShield of South Carolina is a Medicare Advantage PPO and HMO plan with a Medicare contract. BlueCross Essential, Rx Value and BlueCross Rx Plus are stand-alone prescription drug plans with a Medicare contract. Enrollment in BlueCross Total, BlueCross Total Value, BlueCross Blue Basic, BlueCross Secure, BlueCross Essential, BlueCross Rx Value or BlueCross Rx Plus depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year.

Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of South Carolina Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call Customer Service or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

BlueCross BlueShield of South Carolina does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in our health plans, when we enroll members or provide benefits. Free language interpretation services are available for those who cannot read or speak English. Read our Non-Discrimination Statement and Foreign Language Access policy.