Blue Cross MedicareRx Value Part D Plan S5715-010 Details for Oklahoma
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Blue Cross MedicareRx Value is a 2025 Medicare Part D plan from Blue Cross and Blue Shield of IL, NM, OK, TX 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 Cross MedicareRx Value is a cost-sharing plan that has a $117.30 monthly premium, an initial coverage limit of $5,030, a $590.00 annual deductible, and an out-of-pocket threshold of $8,000. *CMS rated this plan 3 (Average) out of 5 stars.
See more Medicare Part D Plans in Oklahoma.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5715-010 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $117.30/mo |
| Deductible: | $590.00/yr |
| Benefit Type: | Enhanced |
| Low Income Subsidy: | Yes |
| Availability: | Oklahoma |
| Insured By: | Blue Cross and Blue Shield of IL, NM, OK, TX |
Prescription Drug Plan Premium
Although Blue Cross MedicareRx Value '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 Blue Cross and Blue Shield of IL, NM, OK, TX plan.
| Basic Part D Premium: | $95.50 |
| Supplemental Part D Premium: | $21.80 |
| Total Part D Premium: | $117.30 |
| Low Income Premium Subsidy: | $49.75 |
| Low Income Premium Subsidy CMS Pays: | $49.80 |
| Low Income Subsidy Premium: | $67.50 |
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 Blue Cross and Blue Shield of IL, NM, OK, TX begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Blue Cross MedicareRx Value 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 | $1.00 | $10.00 | $10.00 |
| Generic* | $8.00 | $20.00 | $20.00 |
| Preferred Brand* | $45.00 | $47.00 | $47.00 |
| Non-Preferred Drug | 47.00% | 50.00% | 50.00% |
| Specialty Tier | 25.00% | 25.00% | 25.00% |
| *Deductible does not apply. | |||
CMS 5-Star Rating Marks
The following table shows the quality ratings for this Blue Cross and Blue Shield of IL, NM, OK, TX 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.
Contact Blue Cross and Blue Shield of IL, NM, OK, TX
| Plan Website: | Blue Cross and Blue Shield of IL, NM, OK, TX |
|---|---|
| Formulay Information: | Blue Cross and Blue Shield of IL, NM, OK, TX Formulary Information |
| Pharmacy Information: | Blue Cross and Blue Shield of IL, NM, OK, TX Pharmacy Information |
| Prospective Part D Members: | (877)213-1817 |
| 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
- Blue Cross and Blue Shield of IL, NM, OK, TX, "http://getblueil.com/pdp", Last Accessed October 13, 2024
- Medicare.gov, "Drug coverage (part D)", Last Accessed March 2, 2024
- Medicare.gov, "How Part D works with other insurance", Last Accessed March 14, 2024
- Medicare.gov, "Catastrophic coverage", Last Accessed March 13, 2024
- SSA.gov, "Understanding the Extra Help With Your Medicare", 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.