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BlueMedicare Premier Rx (PDP)
Health Insurance Company: Arkansas Blue Medicare
Medicare Prescription Drug Part D Plan Details
$159 /mo
monthly premium
BlueMedicare Premier Rx (PDP)
Coverage
Overall Star Rating (2025)
- Rx
General Plan Details
Prescription Drug Deductible
$0
Preferred Generic copay
$0
Preferred Brand copay
$47
Eligible for Low Income Subsidy
No
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$5.00 copay (30-day supply)
$15.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$141.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
34% coinsurance (30-day supply)
34% coinsurance (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
Rx Drug Coverage - Standard Mail Order Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$5.00 copay (30-day supply)
$15.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$141.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
34% coinsurance (30-day supply)
34% coinsurance (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
Plan Links
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Where This Plan is Available
State:
Counties:
Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saint Francis, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
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Additional Plan Info
Plan Year:
2025
Insurance Company Website:
Arkansas Blue Medicare