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Oct 15th - Dec 7th

Enroll for 2025 coverage

Prescription Blue Select (PDP)

Health Insurance Company: Blue Cross Blue Shield of Michigan

Medicare Prescription Drug Part D Plan Details

$123 /mo

monthly premium

Prescription Blue Select (PDP)

Coverage

Overall Star Rating (2025)

out of 5 stars

General Plan Details

Prescription Drug Deductible

$590

Preferred Generic copay

Preferred Brand copay

Eligible for Low Income Subsidy

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

$1.00 copay (30-day supply)
$3.00 copay (90-day supply)

Tier 2: Generic

$6.00 copay (30-day supply)
$18.00 copay (90-day supply)

Tier 3: Preferred Brand

23% coinsurance (30-day supply)
23% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

25% coinsurance (30-day supply)
25% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$6.00 copay (30-day supply)
$18.00 copay (90-day supply)

Tier 2: Generic

$11.00 copay (30-day supply)
$33.00 copay (90-day supply)

Tier 3: Preferred Brand

23% coinsurance (30-day supply)
23% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

25% coinsurance (30-day supply)
25% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$6.00 copay (30-day supply)
$18.00 copay (90-day supply)

Tier 2: Generic

$11.00 copay (30-day supply)
$33.00 copay (90-day supply)

Tier 3: Preferred Brand

23% coinsurance (30-day supply)
23% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

25% coinsurance (30-day supply)
25% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$1.00 copay (30-day supply)
$3.00 copay (90-day supply)

Tier 2: Generic

$6.00 copay (30-day supply)
$18.00 copay (90-day supply)

Tier 3: Preferred Brand

23% coinsurance (30-day supply)
23% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

25% coinsurance (30-day supply)
25% 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:

Michigan

Counties:

Alcona, Alger, Allegan, Alpena, Antrim, Arenac, Baraga, Barry, Bay, Benzie, Berrien, Branch, Calhoun, Cass, Charlevoix, Cheboygan, Chippewa, Clare, Clinton, Crawford, Delta, Dickinson, Eaton, Emmet, Genesee, Gladwin, Gogebic, Grand Traverse, Gratiot, Hillsdale, Houghton, Huron, Ingham, Ionia, Iosco, Iron, Isabella, Jackson, Kalamazoo, Kalkaska, Kent, Keweenaw, Lake, Lapeer, Leelanau, Lenawee, Livingston, Luce, Mackinac, Macomb, Manistee, Marquette, Mason, Mecosta, Menominee, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Ontonagon, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Saint Clair, Saint Joseph, Sanilac, Schoolcraft, Shiawassee, Tuscola, Van Buren, Washtenaw, Wayne, Wexford

View all plans in your Michigan County

Additional Plan Info

Plan Year:

2025

Insurance Company Website:

Blue Cross Blue Shield of Michigan

Prescription Blue Select (PDP)

Medicare Prescription Drug Part D Plan Details

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