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Blue Rx PDP Complete A 2025 Medicare Part D Plan Available in Pennsylvania
Blue Rx PDP Complete A 2025 Medicare Part D Plan Available in Pennsylvania
This guide provides an overview of the Blue Rx PDP Complete Medicare Part D plan for 2025. You’ll find important information about the plan's benefits, costs, and star rating, along with details on how to enroll in Pennsylvania. Use the sections below to explore your prescription drug coverage options.
Blue Rx PDP Complete helps lower your prescription drug expenses, whether you’re enrolled in Medicare Part A and/or Part B, or a Medicare Advantage plan without drug coverage in Pennsylvania.
Blue Rx PDP Complete : Part D Plan Overview | |
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Part D Plan ID: | S5593-003 |
Plan Year: | 2025 |
Total Part D Premium: | $168.20 |
Annual Deductible: | $0.00 |
Part D Benefit Type: | Enhanced |
No Deductible Drug Tier: | Not Applicable |
Low Income Subsidy: | Yes |
Insured By: | Highmark Blue Shield |
We're Here to Help You Enroll |
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Understanding Medicare Part D Plan Costs
Blue Rx PDP Complete has various costs beyond just the monthly premium. From deductibles to copayments and coinsurance, it's essential to understand how these expenses work so you can effectively manage your prescription drug costs. The sections below break down each cost component to help you navigate these financial details with ease.
Premium Breakdown
The Blue Rx PDP Complete plan's monthly premium is an important factor in your total costs. Some plans include extra fees or offer financial aid through the Low-Income Subsidy (LIS) program. The following table details the premium costs for this 2025 plan by Highmark Blue Shield.
Basic Part D Premium: | $125.40 |
Supplemental Part D Premium: | $42.80 |
Total Part D Premium: | $168.20 |
Low Income Premium Subsidy: | $48.36 |
Low Income Premium Subsidy CMS Pays: | $48.40 |
Low Income Subsidy Premium: | $119.80 |
IMPORTANT: If you qualify for the Low-Income Subsidy (LIS) program, known as "Extra Help," you could receive assistance with your prescription drug plan costs in Pennsylvania. For more details, visit the Social Security Extra Help page.
Annual Deductible Information
This plan's Medicare Part D annual deductible is $0.00. You will need to pay this deductible amount before Highmark Blue Shield begins covering your prescription drug costs at the pharmacy.
Out-of-Pocket Expenses with this Part D Plan
Beyond the monthly premium and deductible, Blue Rx PDP Complete includes copayments (fixed amounts) and/or coinsurance (a percentage of the cost) that you'll need to pay when filling your prescriptions. The table below outlines these costs in detail.
Drug Tier | Retail | Mail Order | |
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Preferred Generic | $0.00 | $0.00 | |
Generic | $5.00 | $0.00 | |
Preferred Brand | 25.00% | 0.00% | |
Non-Preferred Drug | 49.00% | 0.00% | |
Specialty Tier | 33.00% | 33.00% | |
*Deductible does not apply. |
How the CMS 5-Star Rating Works
Every year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Part D plans on a 5-star scale, with 5 stars representing excellent quality and performance. These ratings consider factors like customer service, member experience, and the safety of prescription drugs. A higher rating reflects better overall quality, helping you choose the best plan for your needs. The table below shows the CMS rating for the Blue Rx PDP Complete plan.
CMS Measure | Star Rating |
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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 |
When to Enroll in Medicare Part D
Timing your enrollment in Medicare Part D is critical. Here are the key periods when you can sign up for or make changes to your plan:
- Initial Enrollment Period (IEP): This seven-month period begins three months before your 65th birthday month. Discover more about your Medicare Initial Enrollment Period.
- Annual Enrollment Period (AEP): Every year between October 15 and December 7, you can make changes to your Medicare Part D plan. Learn about the Annual Enrollment Period.
- Medicare Advantage Open Enrollment Period (MA-OEP): From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare, , so long as you are currently enrolled in a Medicare Advantage plan. Learn more about the MA Open Enrollment Period.
- Special Enrollment Period (SEP): Life events such as relocating or losing coverage can trigger a Special Enrollment Period, allowing changes outside the usual enrollment windows.
How to Enroll in Blue Rx PDP Complete
Here are a few ways to enroll in Blue Rx PDP Complete or a different Medicare Part D plan:
- Online via MedicareEnrollment.com: Compare and get enrolled online by visiting MedicareEnrollment.com.
- Call HealthCompare: Speak with a licensed insurance agent by calling HealthCompare at 833-748-3201 (TTY 711) for personalized assistance (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
- Call 1-800-MEDICARE: You can also call 1-800-MEDICARE (1-800-633-4227) for help with enrollment. TTY users should dial 1-877-486-2048.
- Call the Plan Directly: Contact the plan directly using the information provided below to enroll by phone.
Contact Highmark Blue Shield
Website: | Highmark Blue Shield Plan Page |
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Formulary: | Highmark Blue Shield Formulary Page |
Pharmacy: | Highmark Blue Shield Pharmacy Page |
Prospective Part D Members: | (866)435-1047 |
Prospective Part D TTY Users: | 711 |
Plans Offered Through Medicare.org
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.
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