Blue Rx PDP Complete: Part D Plan S5593-003 Details for West Virginia
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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 Us About 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 |
If you qualify for Original Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program at www.medicare.gov.
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
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.