Preferred pharmacies are for illustration purposes only and are based on a sample from Texas. Preferred pharmacies vary by state.
Among private health insurance providers, Blue Cross Blue Shield (BCBS) isn’t like the rest. This is evident primarily through the organization of the company—it is not a single entity, but an association of 36 independent companies operating under the BCBS license.1 As such, you’ll likely find regional differences and lots of variety when digging into Part D plans from BCBS.
Who might want a Blue Cross Blue Shield Part D plan?
- 40/50 state residents: Blue Cross Blue Shield (BCBS) offers Part D plans in all but 10 states.
- Generic drug takers: Many of BCBS’s Tiers 1 and 2 generics are very affordable.
- Mail order fans: Of the plans we sampled, the mail order option was just as inexpensive as the preferred pharmacy.
Excluded states from Blue Cross Blue Shield Part D plans
You can find a Blue Cross Blue Shield (BCBS) plan in 40 states. If you live in the following states, however, you’ll need to find a different Part D provider:
- New York
- Washington DC
Blue Cross Blue Shield Part D prescription drug plans
As an association of so many companies, it’s hard to pin down umbrella statements about Blue Cross Blue Shield (BCBS) Part D plans. In general, you’ll see plan names like Basic, Plus, Value, Standard, Enhanced, Premier, or Value Plus for BCBS’s prescription coverage. But to understand which plan is right for you, you’ll need to investigate the BCBS plans available in your area and what drugs they cover.
Blue Cross Blue Shield sample plans
|Blue MedicareRx Value (PDP)||Blue Cross MedicareRx Basic (PDP)||MedicareBlue Rx Premier (PDP)|
|Location||Joplin, MO 64801||Dallas, TX 75227||Jackson, Wy 83001|
|Tier 1 (preferred generics)||$1||$1||$0|
|Tier 2 (generic drugs)||$5||$4||$0|
|Tier 3 (preferred brand drugs)||$30||14%||17%|
|Tier 4 (non-preferred drugs)||40%||30%||45%|
|Tier 5 (specialty drugs)||25%||25%||33%|
|Tier 6 (select care drugs)||$0||n/a||n/a|
|Sample Plan #||S5596-043||S5715-014||S5743-004|
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Blue MedicareRx Value (PDP)
The Blue MedicareRx Value Part D plan we sampled has a higher premium than the other two plans we sampled. However, it has a vast network of preferred pharmacies, from Sam’s Club and Walmart to CVS.
Preferred generics and generics under the plan are $1 and $5, respectively, so if you rely mostly on generics, your medications may be quite affordable. Another unique component to the Value plan is Tier 6, which is not found on every Part D plan. Tier 6 drugs are considered highly effective and the best value for treatment, and as such, are provided with $0 copays. If most of your medications are in Tiers 1, 2, or 6 on the formulary, the Blue MedicareRx Value plan may be a good fit for you.
Blue Cross MedicareRx Basic (PDP)
The MedicareRx Basic Part D plan had the lowest premium of all the plans we sampled and a fairly low deductible. The plan’s preferred pharmacies tend to be limited, with just Walgreens and HEB Pharmacies in the network.
Tiers 1 to 3 on the plan offer affordable coverage, with $1, $4, and 14% copays and coinsurance. If your medications fall into these tiers, the Blue Cross MedicareRx Basic could be a good plan for your drug coverage.
MedicareBlue Rx Premier (PDP)
The Premier plan is rated very highly, with a 5/5 Medicare Star Rating overall in quality and performance.
This plan has no deductible, meaning you receive full drug coverage from day one. It also includes Walmart and Sav-on in its list of preferred pharmacies. On top of this, both Tier 1 and 2 drugs are covered with $0 copays, making this plan possibly worth considering for anyone who mostly relies on generics.
However, if more of your medications fall under Tier 4 or 5 of the Premier plan, you may be better off with one of the other two options we sampled, as they cover more of the costs of those tiers.
Bottom Line: if you like options, you may like Blue Cross Blue Shield Part D plans
Blue Cross Blue Shield (BCBS) plans could offer plenty to choose from for your Part D needs.
If you like the options provided by a large company but with the feel of a regional provider, you may want to consider BCBS. With anywhere from two to four plans to choose from in most states, you could have options that other companies may not be able to provide.
If you’d like to find a BCBS plan, call the number below.
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Want to learn more?
Blue Cross Blue Shield (BCBS) offers far more than Part D coverage; they also sell Medigap plans to supplement your Original Medicare. Or, to bundle all your Medicare coverage into one plan, consider Medicare Advantage (Part C).
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