Blue Rx PDP Complete: Part D Plan S5593-003 Details for West Virginia
Blue Rx PDP Complete is a 2025 Medicare Part D plan from Highmark Blue Shield that's available to people with Medicare Part A and/or Part B or a Medicare Advantage plan that does not include prescription drug plan benefits
Blue Rx PDP Complete is a cost-sharing plan that has a $168.20 monthly premium, an initial coverage limit (ICL) of $2,000, and a $0.00 annual deductible. The ICL adjusts annually with inflation. *This plan is rated 3.5 (Above Average) stars out of 5 stars by CMS.
See more Medicare Part D Plans in West Virginia.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5593-003 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $168.20/mo |
| Deductible: | $0.00/yr |
| Benefit Type: | Enhanced |
| Low Income Subsidy: | Yes |
| Availability: | West Virginia |
| Insured By: | Highmark Blue Shield |
Prescription Drug Premium with Extra Help
Although Blue Rx PDP Complete's monthly premium is bundled with the total plan cost, some plans may receive low-income subsidy (LIS) assistance known as Extra Help. The following table outlines the LIS available through this Highmark Blue Shield plan (if any).
| Low Income Premium Subsidy: | $48.36 |
| Low Income Premium Subsidy CMS Pays: | $48.40 |
| Low Income Subsidy Premium: | $119.80 |
The Social Security Extra Help page has more information about the Low-Income Subsidy (“Extra Help”) program.
Prescription Drug Plan Deductible
This plan's Medicare Part D annual deductible is $0.00. You must pay this amount at the pharmacy before Highmark Blue Shield begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Blue Rx PDP Complete has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic | $0.00 | $0.00 | |
| Generic | $5.00 | $0.00 | |
| Preferred Brand | 25.00% | 0.00% | |
| Non-Preferred Drug | 49.00% | 0.00% | |
| Specialty Tier | 33.00% | 33.00% | |
| *Deductible does not apply. | |||
2025 CMS Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0. Here are the most recent CMS ratings for this plan.
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
The true value of any Medicare Part D plan can only be judged by how well it covers your medications.
Contact Highmark Blue Shield
| Plan Website: | Highmark Blue Shield |
|---|---|
| Formulay Information: | Highmark Blue Shield Formulary Information |
| Pharmacy Information: | Highmark Blue Shield Pharmacy Information |
| Prospective Part D Members: | (866)435-1047 |
| Prospective Part D TTY Users: | 711 |
Citations & References
- Highmark Blue Shield, "http://medicare.highmark.com", Last Accessed March 1, 2025
- Medicare.gov, "How to get prescription drug coverage", Last Accessed March 2, 2024
- Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed March 1, 2024
- Medicare.gov, "Costs for Medicare drug coverage", Last Accessed March 3, 2024
- SSA.gov, "Apply for Medicare Part D Extra Help program", Last Accessed March 9, 2024
- CMS.gov, "Landscape Source Files", Last Accessed March 1, 2025
- CMS.gov, "Medicare Part C & D Performance", Last Accessed March 1, 2025
- CMS.gov, "Benefits Data", Last Accessed March 1, 2025