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Blue Rx PDP Complete (PDP)

Health Insurance Company: Highmark Blue Shield

Medicare Prescription Drug Part D Plan Details

$168 /mo

monthly premium

Blue Rx PDP Complete (PDP)

Coverage

Overall Star Rating (2025)

3.5

out of 5 stars

General Plan Details

Prescription Drug Deductible

Preferred Generic copay

Preferred Brand copay

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

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

Tier 3: Preferred Brand

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

Tier 4: Non-Preferred Drug

49% coinsurance (30-day supply)
49% coinsurance (90-day supply)

Tier 5: Specialty Tier

33% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

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

Tier 2: Generic

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

Tier 3: Preferred Brand

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

Tier 4: Non-Preferred Drug

49% coinsurance (30-day supply)
49% coinsurance (90-day supply)

Tier 5: Specialty Tier

33% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$10.00 copay (90-day supply)

Tier 2: Generic

$25.00 copay (90-day supply)

Tier 3: Preferred Brand

25% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

49% coinsurance (90-day supply)

Tier 5: Specialty Tier

33% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$0.00 copay (90-day supply)

Tier 2: Generic

$12.50 copay (90-day supply)

Tier 3: Preferred Brand

25% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

49% coinsurance (90-day supply)

Tier 5: Specialty Tier

33% coinsurance (30-day supply)

Plan Links

Plan Link

Doctor Lookup

Drug Link

Ready to Enroll Online?

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Mon-Fri: 8am-9pm, Sat: 8am-8pm ET

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Where This Plan is Available

State:

West Virginia

Counties:

Barbour, Berkeley, Boone, Braxton, Brooke, Cabell, Calhoun, Clay, Doddridge, Fayette, Gilmer, Grant, Greenbrier, Hampshire, Hancock, Hardy, Harrison, Jackson, Jefferson, Kanawha, Lewis, Lincoln, Logan, Marion, Marshall, Mason, Mcdowell, Mercer, Mineral, Mingo, Monongalia, Monroe, Morgan, Nicholas, Ohio, Pendleton, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Wayne, Webster, Wetzel, Wirt, Wood, Wyoming

View all plans in your West Virginia County

Additional Plan Info

Plan Year:

2025

Insurance Company Website:

Highmark Blue Shield

Blue Rx PDP Complete (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