Blue Rx PDP Plus Part D Plan S5593-002 Details for West Virginia
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Blue Rx PDP Plus is a 2025 Medicare Part D plan from Highmark Blue Shield that's available to individuals enrolled in a Medicare Advantage plan without prescription drug plan benefits or Medicare Part A and/or Part B.
This plan has a monthly premium of $143.20, an initial coverage limit of $5,030, an out-of-pocket threshold of $8,000, and a $590.00 deductible that must be paid before cost-sharing begins. *This plan has an overall rating of 3.5 (Above Average) out of 5 stars.
See more Medicare Part D Plans in West Virginia.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5593-002 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $143.20/mo |
| Deductible: | $590.00/yr |
| Benefit Type: | Basic |
| Low Income Subsidy: | Yes |
| Availability: | West Virginia |
| Insured By: | Highmark Blue Shield |
Prescription Drug Plan Premium
Although Blue Rx PDP Plus '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 Highmark Blue Shield plan.
| Basic Part D Premium: | $143.20 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $143.20 |
| Low Income Premium Subsidy: | $48.36 |
| Low Income Premium Subsidy CMS Pays: | $48.40 |
| Low Income Subsidy Premium: | $94.80 |
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 Highmark Blue Shield begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Blue Rx PDP Plus 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 | $0.00 | $5.00 |
| Generic | $7.00 | $0.00 | $12.00 |
| Preferred Brand | 24.00% | 0.00% | 24.00% |
| Non-Preferred Drug | 40.00% | 0.00% | 50.00% |
| Specialty Tier | 25.00% | 25.00% | 25.00% |
| *Deductible does not apply. | |||
2025 CMS Rating Marks
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 |
Every plan covers drugs differently, so it's important to look at your total cost.
Contact Highmark Blue Shield
| Plan Website: | Highmark Blue Shield |
|---|---|
| Formulay Information: | Highmark Blue Shield Formulary Information |
| Pharmacy Information: | Highmark Blue Shield Pharmacy Information |
| Prospective Part D Members: | (866)435-1047 |
| 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
- Highmark Blue Shield, "http://medicare.highmark.com", 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, "Costs for Medicare drug coverage", Last Accessed March 3, 2024
- Medicare.gov, "Help with drug costs", Last Accessed February 19, 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.