Blue Rx PDP Complete A 2025 Medicare Part D Plan for Pennsylvania
Blue Rx PDP Complete A 2025 Medicare Part D Plan for Pennsylvania
Welcome to your guide to the Blue Rx PDP Complete Medicare Part D plan for 2025. This page covers key details about the plan, including its benefits, costs, and CMS star rating. We’ve also provided enrollment options to help you secure prescription drug coverage in Pennsylvania.
The Blue Rx PDP Complete plan offers valuable coverage to help reduce your prescription drug costs, whether you're enrolled in Medicare Part A and/or Part B, or a Medicare Advantage plan without drug coverage in Pennsylvania.
Blue Rx PDP Complete: Part D Plan Overview | |
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Part D Plan ID: | S5593-003 |
Part D Plan Type: | PDP |
Part D Plan Year: | 2024 |
Monthly Premium: | $195.10 |
Annual Deductible: | $0.00 |
Part D Benefit Type: | Enhanced |
Gap Coverage: | Yes |
Low Income Subsidy: | No |
Availability: | |
Insured By: | Highmark Blue Shield |
Understanding Medicare Part D Plan Costs
When considering Blue Rx PDP Complete, it's important to look beyond the monthly premium. There are additional costs, such as deductibles, copayments, and coinsurance, that can affect your out-of-pocket expenses. The following sections explain each cost element to help you make informed decisions about your prescription drug coverage.
Premium Breakdown
The Blue Rx PDP Complete plan's monthly premium plays a significant role in determining your overall costs. Some plans may also include supplemental charges or offer Low-Income Subsidy (LIS) options. Below is a breakdown of the premium details for this 2024 plan from Highmark Blue Shield.
Basic Part D Premium: | $135.30 |
Supplemental Part D Premium: | $59.80 |
Total Part D Premium: | $195.10 |
Part D Premium with Full LIS Assistance: | $154.90 |
Want to know more about the Low-Income Subsidy (LIS) or "Extra Help" program? This benefit can lower your prescription drug costs. Visit the Social Security Extra Help page to learn more.
Part D Prescription Drug Plan Deductible
The annual Medicare Part D deductible for this plan is $0.00. You are responsible for paying this amount before Highmark Blue Shield starts sharing the cost of your prescriptions.
Out-of-Pocket Expenses with this Part D Plan
Along with the plan's monthly premium and deductible, Blue Rx PDP Complete requires you to pay copayments (a set dollar amount) or coinsurance (a percentage of the drug cost) when picking up your medications. The table below provides a breakdown of these out-of-pocket expenses.
Tier | Preferred | Standard |
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1 (Preferred Generic) | $0.00 copay | $4.00 copay |
2 (Generic) | $5.00 copay | $10.00 copay |
3 (Preferred Brand) | $40.00 copay | $45.00 copay |
4 (Non-Preferred Drug) | 35% | 50% |
5 (Specialty Tier) | 33% | 33% |
How the CMS 5-Star Rating Works
The CMS assigns Medicare Part D plans a star rating, ranging from 1 to 5 stars, based on several factors, including customer service, member satisfaction, and prescription drug safety. This annual rating helps you evaluate the quality of a plan before enrolling. A 5-star rating indicates top-tier performance. Below, you’ll find the CMS rating for the Blue Rx PDP Complete plan.
CMS Measure | Star Rating |
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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 |
When to Enroll in a Medicare Part D Plan
Knowing when to enroll in a Medicare Part D plan is crucial to ensuring you have the coverage you need. Below are the main enrollment periods:
- Initial Enrollment Period (IEP): Your first chance to enroll in Medicare Part D typically starts three months before the month you turn 65 and lasts for seven months. Learn more about when your Initial Enrollment Period begins.
- Annual Enrollment Period (AEP): Every year from October 15 to December 7, you can join, switch, or drop your Medicare Part D plan. Get details about the Medicare Annual Enrollment Period.
- Medicare Advantage Open Enrollment Period (MA-OEP): From January 1 to March 31, you can change your Medicare Advantage plan or switch back to Original Medicare (with or without Part D). Explore the Medicare Advantage Open Enrollment Period.
- Special Enrollment Period (SEP): Certain events, like moving or losing other coverage, may qualify you for a Special Enrollment Period, allowing you to enroll or change plans outside the usual periods.
How to Enroll in Blue Rx PDP Complete
Ready to enroll in Blue Rx PDP Complete or another Medicare Part D plan? Here are your options:
- Call HealthCompare: Speak with a licensed agent by calling HealthCompare at 877-388-0596 (TTY 711) for personalized assistance.
- Online via MedicareEnrollment.com: Compare and enroll in plans online by visiting MedicareEnrollment.com.
- Call 1-800-MEDICARE: You can also call 1-800-MEDICARE (1-800-633-4227) for help with enrollment. TTY users should dial 1-877-486-2048.
- Call the Plan Directly: Contact the plan directly using the information provided below to enroll by phone.
Contact Highmark Blue Shield
Plan Website: | Highmark Blue Shield Plan Information |
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Formulay Information: | Highmark Blue Shield Formulary Information |
Pharmacy Information: | Highmark Blue Shield Pharmacy Information |
Prospective Members: | (866)435-1047 |
TTY Users: | (800)227-8210 |
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
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