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Blue MedicareRx – Blue Cross Part D Plan Vary By State

Getting your prescription coverage with Blue MedicareRx Doctor with Prescription

Blue Cross Blue Shield Medicare Part D coverage is referred to as Blue MedicareRx. When the Part D benefit was introduced in 2006 Blue Cross began offering prescription drug plans for people with Medicare under the Part D guidelines.

Medicare Part D Plans are offered by private insurance companies that are approved and contracted with The Centers for Medicare and Medicaid Services (CMS).

Blue Medicare Rx Plans are offered State-by-State and may not be available in all States. Plan benefits and plan premiums can vary by State. This is true of Medicare Part D Plans for all companies although some companies offer plans in all 50 States.

What the Blue Cross Part D plans do have in common with Part D plans from other companies is the Standard Benefit Model. These are the guidelines set by CMS related to such things as maximum annual deductible and when you reach the coverage gap.

Blue MedicareRx benefits

Although Part D benefits are optional you are highly encouraged to participate in the program. Evidence of this can be seen in the Part D Late Enrollment Penalty imposed by the government if you decide to wait until after your initial Open Enrollment Period to take part in the program.

The Blue Cross Part D benefit is an annual benefit that may be renewed annually. Insurance companies have the option of not renewing a Part D Plan for a particular State or can change the plan’s benefits and premiums.

You should review your Part D coverage on an annual basis to ensure that any changes will still give you the coverage you need. This is true of any Part D coverage no matter which insurance company sponsors the benefits.

Why Part D Formularies are Key to Choosing the Right Plan

When you choose to enroll in a Blue MedicareRx Part D Plan you will:

  • Have more than one plan to choose from
  • Know which drugs are covered by the plan
  • Generally have fixed copay and coinsurance percentage amounts for each drug tier
  • Enjoy a large network of pharmacies
  • Have access to a convenient mail-order program

To get specific information on plans available to you it will be necessary for you to visit a Blue Cross Blue Shield website specific to your State.

When to enroll in a Blue Cross Part D Plan

The best time to enroll in Blue Medicare Rx is when you’re first eligible for Medicare. You have a 7 month window to join a Part D Plan. The period begins 3 months before the month you turn 65, the month you turn 65 and 3 months after the month you turn 65.

If you are eligible for Medicare due to a disability you can enroll during the 3 months before to 3 months after your 25th month of receiving disability benefits.

For people already enrolled in Medicare the opportunity to join, drop or switch Medicare Part D coverage is during the Annual Election Period.

Unless you are entitled to a Special Enrollment Period, you will not be allowed to change plans after the annual enrollment period.

The only opportunity to change Part D Plans will be for those people who enrolled in a Medicare Advantage Plan that included Part D, like Blue Medicare PPO.

They can drop their Advantage Plan and enroll in a new Part D Plan. This can be accomplished from January 1st through February 14th during the Annual Dis-enrollment Period.

Blue Cross Blue Shield Medicare Rx Plans are a viable option for many people on Medicare.  Visit the Blue Cross website for your State to learn about what Blue MedicareRx options you have available.





  1. Kathleen Bolton

    I have the PPO Advantage plan and can’t get anyone to tell me if my travel immunizations are covered.

  2. Kathleen, Your provider should be able to give you this info, as they will generally not provide the service unless they know who is going to pay them… you or the insurance company. If the travel immunizations are elective and original Medicare doesn’t cover them, then it’s unlikely the plan will pay for them.

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