2023 Blue Medicare Rx Enhanced (PDP) By Blue Cross and Blue Shield of North Carolina
Blue Medicare Rx Enhanced (PDP) S5540-004 is a Enhanced Alternative Medicare (Part-D) Prescription Drug Plan by Blue Cross and Blue Shield of North Carolina. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. The Blue Medicare Rx Enhanced (PDP) plan has a monthly drug premium of $132.50 and a $0 drug deductible.
S5540-004 Part-D Summary of Bennefits
|Plan Name:||Blue Medicare Rx Enhanced (PDP)|
|Provider:||Blue Cross and Blue Shield of North Carolina|
|Monthly Drug Premium:||$132.50|
|Tiers with No Deductible:||0|
Deductible and Premium for Blue Medicare Rx Enhanced (PDP)
The Blue Medicare Rx Enhanced (PDP) plan has a monthly drug premium of $132.50 and a $0 drug deductible. This Blue Cross and Blue Shield of North Carolina plan offers a $82.90 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $49.60 this Premium covers any enhanced plan benefits offered by Blue Cross and Blue Shield of North Carolina above and beyond the standard PDP benefits. This can include additional help in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $132.5. The Part D Total Premium is the combined total of the supplemental and basic premiums for some plans this amount can be lower due to negative premiums.
|Part D Basic Premium:||$82.90|
|Benchmark:||not below the regional benchmark|
|Part D Supplemental Premium||$49.60|
|Benefit Type:||Enhanced Alternative|
|Total Part D Premium:||$132.5|
Blue Cross and Blue Shield of North Carolina Premium Assistance
The Low Income Subsidy (LIS) helps seniors with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Blue Medicare Rx Enhanced (PDP) medicare insurance plan offers a $94.10 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $103.7 for 75% low income subsidy $113.3 for 50% and $122.9 for 25%.
|$0 Premium with Full LIS:||No|
|Full LIS Premium:||$94.10|
|75% LIS Premium:||$103.7|
|50% LIS Premium:||$113.3|
|25% LIS Premium:||$122.9|
S5540-004 Gap Coverage
In 2023 once you and your plan provider have spent $4660 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will still receive a 75% discount on covered brand-name drugs and a discount on generic drugs. Once you reach the coverage gap you will pay 25% of the plans cost for covered brand-name prescription drugs and 25% on generic drugs unless your plan offers additional coverage. This Blue Cross and Blue Shield of North Carolina plan offer additional coverage through the gap.
S5540-004 Formulary or Drug Prices
Blue Medicare Rx Enhanced (PDP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
*Initial Coverage Phase and 30 day supply
Blue Medicare Rx Enhanced (PDP) Plan Reviews
|2022 Overall Rating|
|Drug Plan Customer Service|
|Complaints and Changes in the Drug Plan|
|Member Experience with the Drug Plan|
|Drug Safety and Accuracy of Drug Pricing|
Member Experience with the Drug Plan
|Rating of Drug Plan|
|Getting Needed Prescription Drugs|
Drug Safety and Accuracy of Drug Pricing
|MPF Price Accuracy|
|Drug Adherence for Diabetes Medications|
|Drug Adherence for Hypertension (RAS antagonists)|
|Drug Adherence for Cholesterol (Statins)|
|MTM Program Completion Rate for CMR|
Ratings For Member Complaints and Changes in the Drug Plans Performance
|Complaints about the Drug Plan|
|Members Choosing to Leave the Plan|
|Drug Plan Quality Improvement|
Blue Medicare Rx Enhanced (PDP) Drug Plan Customer Service Ratings
|Call Center, TTY, Foreign Language|
Plans as of October 1, 2022.
Notes: Data are subject to change. All contracts for 2020 have been not finalized. For 2020, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Includes 2020 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.