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.

Blue Shield Rx Plus (PDP) vs. Blue Shield Rx Enhanced (PDP)

Blue Shield PDP plans are designed to fit your unique coverage needs and budget with affordable copayment and coinsurance amounts.

With a Blue Shield Medicare Prescription Drug Plan (PDP), you can get the help you need to pay for generic and brand-name drugs not covered by Original Medicare. You may even save money if you obtain a 90-day supply of your maintenance medication¹ at a retail pharmacy that offers preferred cost-sharing or at our mail service pharmacy.

  Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP)

Monthly plan premium

$168.90

$188.40

Annual deductible

$5452

$0

Formulary

Basic

Enhanced PDP3

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

$1/$9

$2/$11

Tier 2: Generic Drugs

$14/$20

$7/$14

Tier 3: Preferred Brand Drugs

$45/$47

$43/$47

Tier 4: Non-Preferred Drugs

47%/50%

47%/50%

Tier 5: Specialty Tier Drugs

25%/25%

33%/33%
Coverage Gap 25% brand drugs/25% generic drugs 25% brand drugs/25% generic drugs

 

All copay and coinsurance amounts reflect 30-day supply obtained from a network preferred cost-sharing pharmacy or standard cost-sharing pharmacy, respectively.

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Vaccines & insulin

Blue Shield PDP plans cover most Part D vaccines at no cost to you, even if you haven’t paid your deductible, if applicable. If you have questions, contact Customer Service for more information.

You also won’t pay more than $35 for a one-month supply of each insulin product covered by a Blue Shield Prescription Drug plan, no matter what cost-sharing tier it is on, 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.

Explore formulary

Is my pharmacy in network?

Learn about retail, mail services and specialty pharmacies and locate a pharmacy near you.

Explore the network

What will my prescription cost?

Compare the cost of your medications against other available options with the Price Check my Rx tool. 

Check your price

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.

Learn more

Medicare Advantage Prescription Drug Plans

Medicare Advantage Prescription Drug Plans (MAPD) provide comprehensive coverage for Medicare Parts A and B and also include coverage for Prescription Drugs (Part D). Blue Shield offers HMO and PPO plans in various counties across California. Plans and benefits vary by county.

Learn more

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.

Find plan documents

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.

Book an appointment

Join a Medicare event

Attend a free live or online seminar to learn more about Medicare and get your questions answered. 

Find an event

Ready to enroll?

Enrolling online is easy! Simply explore plans in your area to find the plan that fits your needs and budget.

Enroll now

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 Note: Specialty tier (Tier 5) drugs and drugs identified on the Formulary drug list as non-extended day supply (NDS) are only available with a 30-day supply.

2 Does not apply to Blue Shield Rx Plus (PDP) Tier 1: Preferred Generic Drugs

3 Blue Shield Rx Enhanced (PDP) has a more robust formulary than the Blue Shield Rx Plus (PDP)

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Page last updated: 10/01/2023

*Free copy with no obligation to enroll.

© California Physician’s Service DBA Blue Shield of California 1999-2024. All rights reserved.

California Physician’s Service DBA Blue Shield of California is an independent member of the Blue Shield Association.

Blue Shield of California 601 12th Street, Oakland, CA 94607.

For Blue Shield Medicare Advantage Plans: Blue Shield of California is an HMO, HMO D-SNP, PPO and a PDP plan with a Medicare contract and a contract with the California State Medicaid Program. Enrollment in Blue Shield of California depends on contract renewal.

 
 
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