This Blue Cross Blue Shield of Michigan Part D plan is for members who want basic prescription coverage. It offers an expansive pharmacy network that includes major drug store chains and most of Michigan’s retail pharmacies.
STARTING COPAY
$0
Deductible
$505
MONTHLY PREMIUM
$94.50
This plan costs $94.50 per month.
$505 deductible for Tiers 2-5 drugs
Copays start at $0 for Tier 1 generic drugs. You'll need to meet your $505 pharmacy deductible for drugs on tiers 2-5. Some drugs may cost more if you choose a pharmacy in our standard network.
The formulary, or drug list, has all the drugs this plan covers. See if it covers yours (PDF).
• You can fill your prescriptions at more than 96.8% of pharmacies in Michigan. Find a pharmacy.
• Mail-order and 90-day prescriptions are available.
• You're covered if you need to fill a prescription while traveling within the U.S.
Commonly prescribed generic versions of brand medications. You’ll pay the least for these drugs at the pharmacy.
Preferred pharmacy: $0
Standard pharmacy: $5
Although you’ll pay more at the pharmacy for these generic drugs, they're more cost-effective than brand medications.
Preferred pharmacy: $3
Standard pharmacy: $8
Brand drugs that aren’t available yet as a generic.
Preferred pharmacy: $30
Standard pharmacy: $35
Because there are alternatives for the drugs in this tier, you’ll pay more for them at the pharmacy.
Preferred pharmacy: 37% of the cost
Standard pharmacy: 37% of the cost
Specialty drugs are used to treat complex conditions like cancer and multiple sclerosis. Although they can be generic or brand, they usually need special handling and approval. You may have to order them through a specialty pharmacy.
Preferred pharmacy: 25% of the cost
Standard pharmacy: 25% of the cost
Generic: 25% of the cost
Brand: 25% of the cost
Generic drugs: $4.15 copay or 5% of the cost, whichever is greater
Other drugs: $10.35 copay or 5% of the cost, whichever is greater
This brochure explains our Medicare Part D plans so you can choose the best option for you.
• 2023 Medicare Plan Comparison Guide (PDF)
This booklet explains how to use this plan's benefits. It also lists some of the things this plan doesn't cover.
This document lists important features and rules for this plan. It also shows you the differences between benefits for Original Medicare, this plan and our other Prescription Blue PDP plans.
Use this drug list, also called a formulary, to see if this plan covers your prescription.
• Prescription Blue PDP Select Comprehensive Formulary (PDF)
Use the formulary updates to quickly see the most recent changes to the drug list.
• Prescription Blue PDP Select Formulary updates (PDF)
If your prescription needs step therapy or prior authorization, use this document to learn more.
• Prior Authorization and Step Therapy Program (PDF)
You can learn more about how these documents work together in our Help Center.
Find a pharmacy in our network where you can fill your prescriptions.
If you meet certain income and resource limits, you may qualify for help paying for your prescription drug costs through the low-income subsidy.
If you're eligible, see what your monthly premium would be (PDF).
The easiest way to enroll in this plan is online. Or call us at 1-888-563-3307. TTY users call 711. You can also print, fill out and mail this paper application.
$505 deductible for Tiers 2-5 drugs
Copays start at $0 for Tier 1 generic drugs. You'll need to meet your $505 pharmacy deductible for drugs on tiers 2-5. Some drugs may cost more if you choose a pharmacy in our standard network.
The formulary, or drug list, has all the drugs this plan covers. See if it covers yours (PDF).
• You can fill your prescriptions at more than 96.8% of pharmacies in Michigan. Find a pharmacy.
• Mail-order and 90-day prescriptions are available.
• You're covered if you need to fill a prescription while traveling within the U.S.
Commonly prescribed generic versions of brand medications. You’ll pay the least for these drugs at the pharmacy.
Preferred pharmacy: $0
Standard pharmacy: $5
Although you’ll pay more at the pharmacy for these generic drugs, they're more cost-effective than brand medications.
Preferred pharmacy: $3
Standard pharmacy: $8
Brand drugs that aren’t available yet as a generic.
Preferred pharmacy: $30
Standard pharmacy: $35
Because there are alternatives for the drugs in this tier, you’ll pay more for them at the pharmacy.
Preferred pharmacy: 37% of the cost
Standard pharmacy: 37% of the cost
Specialty drugs are used to treat complex conditions like cancer and multiple sclerosis. Although they can be generic or brand, they usually need special handling and approval. You may have to order them through a specialty pharmacy.
Preferred pharmacy: 25% of the cost
Standard pharmacy: 25% of the cost
Generic: 25% of the cost
Brand: 25% of the cost
Generic drugs: $4.15 copay or 5% of the cost, whichever is greater
Other drugs: $10.35 copay or 5% of the cost, whichever is greater
This brochure explains our Medicare Part D plans so you can choose the best option for you.
• 2023 Medicare Plan Comparison Guide (PDF)
This booklet explains how to use this plan's benefits. It also lists some of the things this plan doesn't cover.
This document lists important features and rules for this plan. It also shows you the differences between benefits for Original Medicare, this plan and our other Prescription Blue PDP plans.
Use this drug list, also called a formulary, to see if this plan covers your prescription.
• Prescription Blue PDP Select Comprehensive Formulary (PDF)
Use the formulary updates to quickly see the most recent changes to the drug list.
• Prescription Blue PDP Select Formulary updates (PDF)
If your prescription needs step therapy or prior authorization, use this document to learn more.
• Prior Authorization and Step Therapy Program (PDF)
You can learn more about how these documents work together in our Help Center.
Find a pharmacy in our network where you can fill your prescriptions.
If you meet certain income and resource limits, you may qualify for help paying for your prescription drug costs through the low-income subsidy.
If you're eligible, see what your monthly premium would be (PDF).
The easiest way to enroll in this plan is online. Or call us at 1-888-563-3307. TTY users call 711. You can also print, fill out and mail this paper application.