Medicare Prescription Drug Plans
Blue Shield standalone Medicare Prescription Drug Plans (PDP) provide a variety of coverage options for your prescription drug costs. PDP plans pair well with Medicare Supplement plans and can complement your coverage. Call today to learn more (800) 260-9607†.
What is Medicare Part D?
Medicare Prescriptions Drug Plans are known as Medicare Part D. They provide prescription drug coverage, which Medicare Parts A and B do not. They are designed to be paired with parts A and B. Blue Shield offers two Medicare Part D plans; Blue Shield Rx Plus (PDP) and Blue Shield Rx Enhanced (PDP). The plans provide coverage options for your prescription drug costs.
Blue Shield Rx Plus (PDP) vs. Blue Shield Rx Enhanced (PDP)
Blue Shield Prescription Drug Plans (Medicare Part D) are designed to fit your unique prescription drug coverage needs and budget with affordable copay and coinsurance amounts. Blue Shield Rx Plus offers a lower monthly premium, an annual deductible, and higher copays. Blue Shield Rx Enhanced has a higher monthly premium, no deductible, and lower copays. See the table below.
| Blue Shield Rx Plus (PDP) | Blue Shield Rx Enhanced (PDP) | |
|---|---|---|
Monthly plan premium |
$161.70 |
$183.50 |
Annual deductible |
$5901 |
$0 |
Formulary |
Blue Shield Rx Plus (PDP) |
Blue Shield Rx Enhanced2 (PDP) |
Network pharmacies with preferred cost-sharing |
Albertsons/Osco/Sav-on, Costco, CVS Pharmacy (including CVS pharmacy at Target), Safeway, Vons, Walmart and Ralphs | |
Tier 1: Preferred generic drugs |
$3/$9 |
$2/$11 |
Tier 2: Generic drugs |
$14/$20 |
$7/$14 |
Tier 3: Preferred brand drugs |
18%/20% |
$43/$47 |
Tier 4: Non-preferred drugs |
47%/50% |
47%/50% |
Tier 5: Specialty tier drugs |
25%/25% |
33%/33% |
All copay and coinsurance amounts reflect a 30-day supply from a network preferred cost-sharing pharmacy or standard cost-sharing pharmacy.
How do I get a Medicare Part D Prescription Drug Plan?
You can add a standalone prescription drug plan to your existing Medicare coverage. Or, you can get coverage through a Medicare Advantage Plan.
Explore Medicare plans in your area
We’ve sent you an email with a link and all the relevant information for the event.
Vaccines and insulin
Blue Shield PDP plans cover most Part D vaccines at no cost to you. This is true even if you haven’t paid your deductible (if applicable). If you have questions, contact Customer Service for more information.
Insulin products are covered by Blue Shield Prescription Drug plans. You won't pay more than $35 for a one-month supply per product no matter what cost-sharing tier you're on. This is true even if you haven’t paid your deductible (if applicable).
Quick links
Is my drug covered?
Our formularies (list of covered drugs) offer extensive options for continuing the care you need.
Is my pharmacy in network?
Learn about retail, home delivery, and specialty pharmacies and locate a pharmacy near you.
What will my prescription cost?
Compare the cost of your medications against other available options with the Price Check my Rx tool.
Is there financial help?
If you have limited income and assets, you may qualify for a Medicare Savings Program to help you pay your Medicare costs.
Medicare Advantage Prescription Drug Plans
Medicare Advantage Prescription Drug Plans (MAPD) provide comprehensive coverage for Medicare Parts A and B and include coverage for Prescription Drugs (Part D). Blue Shield offers HMO, HMO D-SNP, and PPO plans in various counties across California. Plans and benefits vary by county.
Prescription Drug Plan documents
Current members can find plan documents in one place. Visit member resources to find your Evidence of Coverage, Summary of Benefits, pharmacy directories, and more.
Get more information
Connect with us
Get answers to your Medicare questions. Call a Blue Shield Medicare adviser at 800-260-9607 (TTY: 711)† or book an appointment online. No obligation to enroll.
Join a Medicare event
Attend a free live or online seminar to learn more about Medicare and get your questions answered.
Ready to enroll?
Enrolling online is easy! Simply explore plans in your area to find the plan that fits your needs and budget.
Blue Shield of California is a PDP plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. Other pharmacies are available in our network.
1 Does not apply to Blue Shield Rx Plus (PDP) Tier 1: Preferred Generic Drugs
2 Blue Shield Rx Enhanced (PDP) has a more robust formulary than the Blue Shield Rx Plus (PDP)
Blue Shield of California’s pharmacy network includes limited lower-cost, pharmacies with preferred cost sharing in certain counties within California. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost pharmacies with preferred cost sharing in your area, please call the Customer Service on your ID card or consult the online pharmacy directory at blueshieldca.com/medpharmacy2025.
Y0118_24_415A_M Accepted 09172024
H2819_24_415A_M Accepted 09172024
Page last updated: 10/01/2024
