2008 Benefits - Standard Plan

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Our Blue Medicare Rx - Standard Plan meets the standard benefit criteria designed by Medicare. The benefits for our Standard Plan are outlined below.

• $275 deductible
• 25% coinsurance until "coverage gap" begins at $2,510 in total annual drug costs
• Generally 5% coinsurance after "coverage gap" ends
• Extensive list of covered drugs
• A large and accessible pharmacy network

$52.50/month
You pay 100%	$275 deductible Phase 1: You will be responsible for 100% of the first $275 in total prescription drug costs in each calendar year before your prescription drug benefit begins.
You pay 25% BCBSNC pays 75%	25% coinsurance Phase 2: After the first $275, you will be responsible for 25% of the total cost of your prescription drugs. BCBSNC will pay 75% of your total drug costs until they reach a total of $2,510.
You pay 100%	Coverage gap Phase 3: After your total annual drug costs reach $2,510, you will be responsible for 100% of your prescription drug costs until your out-of-pocket expenses reach $4,050. This is referred to as the "coverage gap."
You pay 5% BCBSNC pays 95%	Generally 5% coinsurance Phase 4: After your total annual out-of-pocket costs reach $4,050, you will pay very little for prescription drugs. You will generally pay only 5% (or $2.25 generic/$5.60 brand name, whichever is greater) for prescription drugs and BCBSNC will pay the rest.
All drug types (generic brand name and specialty)

You can also download a printable Summary of Benefits for a description of your benefits.

Standard Plan - Summary of Benefits

For a more comprehensive explanation of your covered benefits, you can download your printable Evidence of Coverage.

Standard Plan - Evidence of Coverage

A broad range of covered drugs

The Blue Medicare Rx drug list is based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list includes more than 3,700 drugs, including generic, brand name and specialty drugs. Many of the most popular prescriptions are included. Certain vaccinations, insulin and insulin injection supplies are also covered. Over-the-counter drugs are not covered because they are excluded by Medicare. To determine which drugs are covered by your plan, use the drug search.

A large and accessible pharmacy network

A large network of pharmacies is at your fingertips. In fact, 97 percent of North Carolina's pharmacies are in our network and we meet or exceed Medicare access requirements in North Carolina. You can also order drugs through our mail-order drug program. Find a network pharmacy near you by searching the pharmacy list.

Coverage when you are traveling

When you are out-of-state, you may visit chain pharmacies included on the pharmacy list, and your prescription will be covered at the in-network cost.