BlueMedicare Premier Rx (PDP)
Contract S5904, plan 001, segment 0 · offered by BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. · CMS PDP Region 11 (Florida).
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Renewed for 2027. CMS carries this plan forward from 2026 under the same id. See every 2026 → 2027 change.
Plan features
| Monthly premium | $164.60 |
|---|---|
| — basic (standard) part | $164.60 |
| — supplemental (enhanced) part | $0.00 |
| Annual deductible | $700.00Tier 6 exempt |
| Out-of-pocket threshold | $2,400.00 |
| Drug benefit type | Basic Alternative |
| $0 premium with full LIS | No |
| Premium with Extra Help (LIS) | $157.30 |
| LIS benchmark status | Above the regional benchmark |
| Formulary tiers | 6 |
| Formulary exception tier | 4 |
| Has a tier the deductible does not apply to | Yes |
| Plan reach | Regional plan |
| Member services | (855)601-9465TTY (800)955-8770 |
The plan’s own pages: Plan website · Formulary · Pharmacy directory
CMS star ratings
- Part D summary rating
- 2.5 out of 5 stars for Part D summary rating
Published per contract, which is how CMS scores them — every plan under contract S5904 shares this rating.
Formulary tiers — preferred pharmacy, initial coverage phase
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $4.00 |
| Tier 2 · Generic | $8.00 |
| Tier 3 · Preferred Brand | 19% |
| Tier 4 · Non-Preferred Drug | 32% |
| Tier 5 · Specialty Tier | 25% |
| Tier 6 · Select Care Drugs | $4.00 |
Cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $4.00 | $4.00 | $4.00 | $12.00 | $12.00 | $12.00 |
| Tier 2: Generic | $8.00 | $8.00 | $8.00 | $24.00 | $24.00 | $24.00 |
| Tier 3: Preferred Brand | 19% | 19% | 19% | 19% | 19% | 19% |
| Tier 4: Non-Preferred Drug | 32% | 32% | 32% | 32% | 32% | 32% |
| Tier 5: Specialty Tier | 25% | 25% | 25% | n/a | n/a | n/a |
| Tier 6: Select Care Drugs | $4.00 | $4.00 | $4.00 | $12.00 | $12.00 | $12.00 |
These are the initial coverage phase amounts, as the plan filed them in its benefit package. The deductible and post-threshold phases are not stated per tier in that filing, so they are not shown here rather than being inferred; the plan's annual out-of-pocket threshold is $2,400.00.
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Complaints about the Drug Plan · D02 | 4 out of 5 stars for Complaints about the Drug Plan | 4 out of 5 stars for Complaints about the Drug Plan |
| Members Choosing to Leave the Plan · D03 | 3 out of 5 stars for Members Choosing to Leave the Plan | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement · D04 | 2 out of 5 stars for Drug Plan Quality Improvement | 5 out of 5 stars for Drug Plan Quality Improvement |
| DD3: Member Experience with the Drug Plan | ||
| Rating of Drug Plan · D05 | 1 out of 5 stars for Rating of Drug Plan | 2 out of 5 stars for Rating of Drug Plan |
| Getting Needed Prescription Drugs · D06 | 1 out of 5 stars for Getting Needed Prescription Drugs | 3 out of 5 stars for Getting Needed Prescription Drugs |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 5 out of 5 stars for MPF Price Accuracy | 5 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Diabetes Medications · D08 | 2 out of 5 stars for Medication Adherence for Diabetes Medications | 2 out of 5 stars for Medication Adherence for Diabetes Medications |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 2 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | 2 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) |
| Medication Adherence for Cholesterol (Statins) · D10 | 3 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 2 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 3 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | 4 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 2 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB) | new measure |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D13 | 3 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | new measure |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under S5904 shares it.
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.