Horizon Medicare Blue Rx Standard: Part D Plan S5993-001 Details
Horizon Medicare Blue Rx Standard is a prescription drug plan from Horizon Blue Cross Blue Shield of New Jersey that's available to people enrolled in Original Medicare or a Medicare Advantage plan without Part D benefits.
This 2025 Medicare Part D plan has a $18.20 monthly premium, $590.00 annual deductible, and a $2,000 initial coverage limit. *This plan is rated 3 (Average) stars out of 5 stars by CMS.
NOTE: The ICL adjusts each year with the rate of inflation.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5993-001 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $18.20/mo |
| Deductible: | $590.00/yr |
| Benefit Type: | Basic |
| Low Income Subsidy: | Yes |
| Availability: | See List |
| Insured By: | Horizon Blue Cross Blue Shield of New Jersey |
Prescription Drug Premium with Extra Help
Although Horizon Medicare Blue Rx Standard'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 Horizon Blue Cross Blue Shield of New Jersey plan (if any).
| Low Income Premium Subsidy: | $56.86 |
| Low Income Premium Subsidy CMS Pays: | $18.20 |
| Low Income Subsidy Premium: | $0.00 |
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 $590.00. You must pay this amount at the pharmacy before Horizon Blue Cross Blue Shield of New Jersey begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Horizon Medicare Blue Rx Standard 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 | $5.00 | |
| Preferred Brand | 20.00% | 20.00% | |
| Non-Preferred Drug | 45.00% | 45.00% | |
| Specialty Tier | 25.00% | 0.00% | |
| *Deductible does not apply. | |||
CMS 5-Star Rating Marks
The following table shows the quality ratings for this Horizon Blue Cross Blue Shield of New Jersey plan. Each year 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.
| 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.
Plan Availability
Horizon Medicare Blue Rx Standard is available in the following states:
Additional {misc_2} Medicare Part D Plan Options in New Jersey
Here are some additional {plan_type_2} plans in your area that might be worth reviewing:
- None.
Contact Horizon Blue Cross Blue Shield of New Jersey
| Plan Website: | Horizon Blue Cross Blue Shield of New Jersey |
|---|---|
| Formulay Information: | Horizon Blue Cross Blue Shield of New Jersey Formulary Information |
| Pharmacy Information: | Horizon Blue Cross Blue Shield of New Jersey Pharmacy Information |
| Prospective Part D Members: | (888)765-7134 |
| Prospective Part D TTY Users: | 711 |
Citations & References
- Horizon Blue Cross Blue Shield of New Jersey, "http://www.horizonblue.com/Medicare", Last Accessed March 1, 2025
- Medicare.gov, "How to get prescription drug coverage", Last Accessed March 2, 2024
- Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed March 1, 2024
- Medicare.gov, "Catastrophic coverage", Last Accessed March 13, 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