2011 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Blue MedicareRx Premier (PDP) by Blue Cross Blue Shield of Georgia | ||||
State: | Georgia | ||||
Plan ID: | S5596 - 011 - 0 Click to see other plans | ||||
Member Services: | 1-866-755-2776 TTY users 1-866-798-7026 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the Blue MedicareRx Premier (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $94.80 | ||||
Annual Deductible: | $0 | ||||
$0 Premium if LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Annual Initial Coverage Limit (ICL): | $2,840 | ||||
Drug Benefit Type ❔ | Enhanced Alternative (EA) | ||||
Additional Gap Coverage? | Many Generics, Some Brands | ||||
Total Number of Formulary Drugs: | 4,499 drugs | Browse the Blue MedicareRx Premier (PDP) Formulary | |||
This plan has 5 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $6.00 | $43.00 | $85.00 | 33% | 33% |
• Number of Drugs per Tier: | 1617 | 563 | 1426 | 554 | 339 |
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in Georgia: | 7,080 members (CMS Region 10) | ||||
Number of Members enrolled in this plan nationally: | 85,087 members |