bcbs mpdp Medicare Prescription Drug Coverage

BCBS MPDP Medicare Prescription Drug Coverage is a vital part of the BCBS MPDP plan.

The plan offers a comprehensive list of covered medications, with over 3,000 prescription drugs included.

Members can expect a low deductible of $480, and copays as low as $3 for generic medications.

This makes it easier for members to afford the medications they need to manage their health conditions.

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With BCBS MPDP, you can enjoy the great benefits you get now, plus lower costs and more approved drugs. This program is exclusively for Blue Cross and Blue Shield Federal Employee Program (FEP) members eligible for Medicare, and you can save money on your prescriptions.

You're eligible if you're an FEP member, enrolled in Medicare Part A and/or Part B primary, and a resident of the U.S. or a U.S. territory. This means you can get more out of your prescription drug coverage without having to pay a separate FEP premium.

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Using the Prescription Drug Cost Tool, you can see if your drug is covered under your plan and what you would pay out-of-pocket with and without MPDP. If you're a member and logged in to MyBlue, you can access a personalized drug cost tool that shows you the cost of prescription drugs for your specific plan.

Eligible members with Medicare get lower out-of-pocket costs for higher cost drugs and additional approved prescription drugs in some tiers than the traditional pharmacy benefit. New for 2025, the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum.

Here's a breakdown of the pharmacy benefits for each plan:

If you're a retiree on Medicare, you're eligible for MPDP, a prescription drug benefit that can save you money on your prescriptions.

MPDP is part of your Blue Cross and Blue Shield Service Benefit Plan coverage, so you don't have to pay a separate premium for your prescription drug coverage.

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With MPDP, you can see if your drug is covered under your plan and what you would pay out-of-pocket with and without MPDP using the Prescription Drug Cost Tool.

The annual pharmacy out-of-pocket maximum is $2,000 per member, separate from the medical out-of-pocket maximum.

Here are the costs for each plan:

To be eligible for the MPDP, you must be a Federal employee Plan (FEP) member enrolled in Medicare Part A and/or Part B primary and a resident of the U.S. or a U.S. territory.

You can order prescriptions and refills at one of the 65,000+ in-network retail pharmacies or through the FEP Mail Service Pharmacy (Basic and Standard Option only).

The MPDP has a tiered system for medication costs, with Tier 1 being generics, Tier 2 being preferred brand names, Tier 3 being non-preferred brand names, and Tier 4 being specialty drugs.

Here's a quick rundown of the tier system:

The FEP Medicare Prescription Drug Program is a prescription drug program with a Medicare contract that offers additional benefits to Federal Employee Plan members.

You'll retain your current FEP health benefits, but with some exciting new perks, as outlined in the 2024 Plan Guide.

Members with the MPDP option will have an annual pharmacy out-of-pocket maximum, capping the amount you'll pay in copays and coinsurance at $3,500 per year for the FEP Blue Focus and Basic option.

This cap is a game-changer, as it means you'll pay nothing for your prescriptions once you reach this limit for the year.

The Standard option has a slightly lower cap of $2,000 per year, but still offers significant savings on prescription costs.

Once you've hit this maximum, you're all set for the rest of the year, with no more out-of-pocket expenses for your prescriptions.

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To be eligible for MPDP, you must be a Federal employee Plan (FEP) member, enrolled in Medicare Part A and/or Part B primary and a resident of the U.S. or a U.S. territory.

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You can order prescriptions and refills at one of the 65,000+ in-network retail pharmacies or through the FEP Mail Service Pharmacy (Basic and Standard Option only).

Here's a breakdown of the prescription tiers:

Specialty drugs are considered tier 4 drugs and can be bought by going to a retail pharmacy or by mail, depending on how the drug is dispensed.

Drug Tiers are a crucial part of prescription drug plans, and understanding them can help you save money on your medications.

The tiers are divided into different levels of cost, with Tier 1 being the lowest-cost option.

Here's a breakdown of the tiers and their corresponding costs:

For example, with FEP Blue Focus, you'll pay a $5 copay for Tier 1 (Generics), while Tier 2 (Preferred brand) costs 40% of the allowance, with a maximum of $350.