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2013 Medicare Prescription Drug Plan Benefit Details for the Blue MedicareRx Plus (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2013 Medicare Prescription Drug Plan Details
Medicare Plan Name:Blue MedicareRx Plus (PDP)
   by HISC - Blue Cross Blue Shield of Oklahoma
State:Oklahoma
Plan ID:S5715 - 011 - 0     Click to see other plans
Member Services:(888) 285-2249 TTY users (888) 285-2252
— 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
Email a copy of the Blue MedicareRx Plus (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$96.60
Annual Deductible:$0
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,970
Drug Benefit Type ❔Enhanced Alternative (EA)
Additional Gap Coverage?All Generics
Total Number of Formulary Drugs:2,905 drugsBrowse the Blue MedicareRx Plus (PDP) Formulary
This plan has 5 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$3.00$10.00$38.00$86.0033%
• Number of Drugs per
  Tier:		6471114364501290
Plan Offers Mail Order?Yes
Plan Type (Reach):Regional Plan
Number of Members enrolled in this plan in Oklahoma:7,128 members     (CMS Region 23)
Number of Members enrolled in this plan nationally:144,967 members
Plan’s Summary Star Rating: 4 out of 5 Stars.
• Customer Service Rating: 4 out of 5 Stars.
• Member Experience Rating: 4 out of 5 Stars.
• Drug Cost Accuracy Rating: 4 out of 5 Stars.




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