Blue MedicareRx Plus PDP for New Hampshire Seniors
| CMS Rating: |  |
|---|---|
| Plan Premium: | $65.80 |
| Pharmacy Co-Pay: | $0.00 |
| Initial Coverage Limit: | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | Few Generics |
| Low Income Subsidy: | No |
| Medicare Formulary: | 3245 |
| PDP ID No: | S5596-001 |
| Plan Year: | 2013 |
| Approved by CMS for: | NH Residents |
| Rx Plan Type: | Regional |
| Members in Region: | 6761 |
2013 Medicare Prescription Drug Plan Overview
Blue MedicareRx Plus (PDP) is an approved Medicare Part D Drug Plan underwritten by Anthem Blue Cross Life and Health Insurance Co for eligible New Hampshire seniors with Medicare benefits.
The monthly premium is $65.80 ($789.60 for a full 12 months) and the pharmacy deductible is $0.00 per year. That means you receive prescription coverage assistance on day one (first dollar coverage).
The plan is based on drug formulary ID 00012350. The formulary offers 3245 FDA approved medications. Be sure to verify that your medications are covered.
New Hampshire seniors, be aware that a few different circumstances may decrease or increase your actual premium. Specifically, if you qualify for Extra Help (full or partial), your premium will decrease. On the other hand, if you have a premium penalty, your premium will be slightly more.
The Blue MedicareRx Plus plan compares well with these plans:
- WellCare Classic at $33.50 per month for New Hampshire Seniors
- AARP MedicareRx Preferred at $35.10 per month for New Hampshire Seniors
- Humana Enhanced at $48.90 per month for New Hampshire Seniors
Blue MedicareRx Plus Initial Coverage
ICP - the Initial Coverage Phase - is where you share the cost of your prescriptions with your insurance company. You and the carrier each pay your share until you hit the Initial Coverage Limit (ICL). In 2013, the ICL is $2,970. This number is adjusted each year. This plan has no deductible so your initial coverage phase begins immediately.
All prescription drugs fall into one of several tiers within the insurance carrier's drug formulary. Carrier use the formulary tiers to manage cost-sharing. Be aware that tiers are not standardized. In other words, carriers assign drugs to the tier they deem most suitable.
In New Hampshire the pharmacy co-pay for prescription drugs is as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $2.00 | 406 Preferred Generics |
| 2 | $7.00 | 1216 Non-Preferred Generics |
| 3 | $45.00 | 414 Preferred Brand Drugs |
| 4 | $90.00 | 237 Non-Preferred Brand Drugs |
| 5 | 33% | 586 Specialty Drugs |
The Initial Coverage Limit with Blue MedicareRx Plus is $2,970.00. This plan does not qualify for a no cost LIS premium.
Blue MedicareRx Plus (PDP) 2013 Coverage Gap
The prescription drug Coverage Gap (aka, "Donut Hole") is the coverage phase where you must pay all of your medication costs. You can learn more about costs in the donut hole by reading What is the Medicare Part D Donut Hole? When you reach the donut hole with the Blue MedicareRx Plus (PDP) plan all depends on your prescriptions.
Here's how the carrier defines the 'donut hole' gap coverage for this policy: Less than 10% of formulary generics are covered, but you must pay for Brand Drugs up to $3727.50.
Blue MedicareRx Plus Plan Members
The number of seniors using the Blue MedicareRx Plus plan nationally is 155,061. In your area (PDP region 1) there are a reported 6,761 seniors using this pharmacy plan. That's based on the previous year's CMS information.
Related Medicare Benefits in NH
More Information About Anthem Blue Cross Life and Health Insurance Co
Anthem was an insurance company which began in the 1980s then merged in 2004 with the Blue Cross Blue Shield organizations of several states, then merged again in late 2004 with WellPoint. The combined company took the WellPoint name. While Anthem no longer exists as a company, the Anthem Blue Cross and Blue Shield brand name is used by WellPoint in 11 states.
The summary (overall) rating for this Anthem Blue Cross Life and Health Insurance Co plan is 2.5 out of 5 based on reviews from 6761 user ratings from the previous year. For more information about the review process, visit http://cms.gov.
