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Blue Cross MedicareRx Value (PDP)

Medicare Prescription Drug Part D Plan Details

Health insurance company offering plan: Blue Cross and Blue Shield of IL, NM, OK, TX

$111 /mo

monthly premium

Coverage

Overall Star Rating (2026)

out of 5 stars

General Plan Details

Prescription Drug Deductible

$615

Preferred Generic copay

Preferred Brand copay

16%

Eligible for Low Income Subsidy

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$4.00 copay (30-day supply)
$12.00 copay (90-day supply)

Tier 3: Preferred Brand

14% coinsurance (30-day supply)
14% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

33% coinsurance (30-day supply)
33% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$5.00 copay (30-day supply)
$15.00 copay (90-day supply)

Tier 2: Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 3: Preferred Brand

16% coinsurance (30-day supply)
16% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

35% coinsurance (30-day supply)
35% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$5.00 copay (30-day supply)
$15.00 copay (90-day supply)

Tier 2: Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 3: Preferred Brand

16% coinsurance (30-day supply)
16% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

35% coinsurance (30-day supply)
35% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$4.00 copay (30-day supply)
$12.00 copay (90-day supply)

Tier 3: Preferred Brand

14% coinsurance (30-day supply)
14% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

33% coinsurance (30-day supply)
33% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Plan Links

Plan Link

Doctor Lookup

Drug Link

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Where This Plan is Available

State:

New Mexico

Counties:

Bernalillo, Catron, Chaves, Cibola, Colfax, Curry, De Baca, Dona Ana, Eddy, Grant, Guadalupe, Harding, Hidalgo, Lea, Lincoln, Los Alamos, Luna, Mckinley, Mora, Otero, Quay, Rio Arriba, Roosevelt, Sandoval, San Juan, San Miguel, Santa Fe, Sierra, Socorro, Taos, Torrance, Union, Valencia

View all plans in your New Mexico County

Additional Plan Info

Plan Year:

2026

Insurance Company Website:

Blue Cross and Blue Shield of IL, NM, OK, TX

Blue Cross MedicareRx Value (PDP)

General Plan Details

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Plan Links

Where This Plan is Available

Additional Plan Info

Health Insurance Companies Offering Plans