MedicareBlue Rx Standard Part D Plan S5743-001 Details for Nebraska
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MedicareBlue Rx Standard is a prescription drug plan from MedicareBlue Rx 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 $51.00 monthly premium, $590.00 annual deductible, $5,030 initial coverage limit, and a $8,000 out-of-pocket threshold. *This plan is rated 3 (Average) stars out of 5 stars by CMS.
See more Top Medicare Part D Plans in Nebraska.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5743-001 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $51.00/mo |
| Deductible: | $590.00/yr |
| Benefit Type: | Basic |
| Low Income Subsidy: | Yes |
| Availability: | Nebraska |
| Insured By: | MedicareBlue Rx |
Prescription Drug Plan Premium
Although MedicareBlue Rx Standard 's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this MedicareBlue Rx plan.
| Basic Part D Premium: | $51.00 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $51.00 |
| Low Income Premium Subsidy: | $50.63 |
| Low Income Premium Subsidy CMS Pays: | $50.60 |
| Low Income Subsidy Premium: | $0.40 |
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 MedicareBlue Rx begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, MedicareBlue 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 | Out of Network |
|---|---|---|---|
| Preferred Generic | $0.00 | $7.00 | $7.00 |
| Generic | $2.00 | $11.00 | $11.00 |
| Preferred Brand | 23.00% | 25.00% | 25.00% |
| Non-Preferred Drug | 48.00% | 50.00% | 50.00% |
| Specialty Tier | 25.00% | 25.00% | 25.00% |
| *Deductible does not apply. | |||
CMS Rating Marks for Plan Year 2025
Each year Medicare rates drug plans (Part D) in several major categories. These ratings are designed to help you understand the quality of care and service you can expect if you join 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 |
You can't judge a Part D plan on its monthly premium or annual deductible. You have to look at the overall cost of your prescriptions.
Contact MedicareBlue Rx
| Plan Website: | MedicareBlue Rx |
|---|---|
| Formulay Information: | MedicareBlue Rx Formulary Information |
| Pharmacy Information: | MedicareBlue Rx Pharmacy Information |
| Prospective Part D Members: | (866)434-2037 |
| 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
- MedicareBlue Rx, "http://www.YourMedicareSolutions.com", Last Accessed October 13, 2024
- 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, "Medicare costs at a glance", Last Accessed March 11, 2024
- SSA.gov, "Apply for Medicare Part D Extra Help program", Last Accessed March 9, 2024
- CMS.gov, "Landscape Source Files", Last Accessed October 3, 2024
- CMS.gov, "Medicare Part C & D Performance", Last Accessed October 11, 2024
- CMS.gov, "Benefits Data", Last Accessed October 9, 2024
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.