2013 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Blue MedicareRx Standard (PDP) by Anthem Blue Cross and Blue Shield | ||||
State: | Ohio | ||||
Plan ID: | S5596 - 013 - 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 Standard (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $32.60 | ||||
Annual Deductible: | $325 | ||||
$0 Premium if LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Annual Initial Coverage Limit (ICL): | $2,970 | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 2,838 drugs | Browse the Blue MedicareRx Standard (PDP) Formulary | |||
This plan has 6 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: | $2.00 | $6.00 | $36.00 | $85.00 | 25% |
• Number of Drugs per Tier: | 247 | 1063 | 562 | 235 | 418 |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | Regional Plan | ||||
Number of Members enrolled in this plan in Ohio: | 9,614 members (CMS Region 14) | ||||
Number of Members enrolled in this plan nationally: | 83,268 members | ||||
Plan’s Summary Star Rating: | 3 out of 5 Stars. | ||||
• Customer Service Rating: | 3 out of 5 Stars. | ||||
• Member Experience Rating: | 2 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 3 out of 5 Stars. |