Frequently Asked Questions

Once I select a Medicare Part D prescription drug plan, can I change plans later?

Yes.  Each year you can start over with a different plan during the Annual Coordinated Election Period, November 15 through December 31 for coverage beginning January 1 of the following year. After you have made your selection you must keep your plan until the next Annual Coordinated Election Period, unless you qualify for a Special Election Period. See Eligibility & Enrollment Periods.

Will BlueRx monthly premiums or benefits change next year? 

The BlueRx’s contract is renewed annually with Medicare. The premiums, benefits, copays and coinsurance amounts can change annually. Members will receive an Annual Notice of Change in the mail prior to Nov. 15 for changes effective the following Jan. 1.

Also, remember everyone has the opportunity to change plans each year during the Annual Coordinated Election Period (Nov. 15 to Dec. 31). 

What is the difference between a preferred and non-preferred brand-name drug?

Preferred brand-name drugs are therapeutically sound, cost-effective brand-name drugs that we encourage members to use within the therapeutic drug classes listed in the formulary. Using preferred drugs helps you save money. You will pay a lower, tier two copay for formulary preferred brand-name drugs.  Non-preferred brand-name drugs are drugs that are still covered under your plan, but at a higher, tier three copay.

If the drug is available in generic, do I have to take the generic?

If a brand drug has a generic equivalent available, and only the generic drug is on the formulary, you can purchase the brand drug, but you will be responsible for 100 percent of the cost. These costs will not count toward your $2,700 Initial Coverage Limit (d) or the $4,350 Catastrophic Coverage Threshold (d). Please talk to your doctor about switching to generics if a generic is available and appropriate for your treatment.

How do I file my prescription drug claims?

To receive benefits for prescription drugs, you must purchase your drugs at a pharmacy that participates in the BlueRx pharmacy network. These participating network pharmacies will submit your claims electronically and you will only pay the applicable copay amounts. If you are in the Coverage Gap (d) phase, you still need to use a participating network pharmacy and show your BlueRx ID card to make sure that you receive the network discount price. Showing your ID will also ensure that your out-of-pockets costs count toward your $4,350 catastrophic coverage threshold.