Blue MedicareRx (PDP)^SM Benefits Overview

Our Medicare Part D coverage offers three plans for you to choose from and benefits include:

• One common formulary no matter which plan you choose
• No deductible options
• Fixed copays and coinsurance
• Benefits during the “coverage gap” with our Plus Plan
• Extra savings when you visit any preferred network pharmacy, or use our mail-order program
• More than 59,700^† network pharmacies nationwide, with 2,500 covered medications, keep you covered while you travel

To see the savings for each of the 2010 plans, use the easy to read placemat.
Reminder: you must continue to pay your Medicare Part B premium.

Blue MedicareRx (PDP) Value Plan - Broad coverage with deductible. This plan may be preferred by those who:

• Prefer a plan with a low deductible
• Want the plan with the lowest premium

     Monthly Premium: $18.50

Blue MedicareRx (PDP) Standard Plan - Basic coverage equal to the federal government's minimum requirements for coverage. This plan may be preferred by those who:

• Want the lowest copay for generics
• Are comfortable paying a deductible

     Monthly Premium: $37.30

Blue MedicareRx (PDP) Plus Plan - Extensive coverage, with generic prescription drugs covered during the coverage gap. This plan may be preferred by those who:

• Like having no deductible while enjoying comprehensive benefits
• Prefer continuous coverage

     Monthly Premium: $70.90

Use the Plan Selector Tool* to help you choose the Blue MedicareRx (PDP) plan that best meets your individual needs.

* By clicking this link you will leave the Blue MedicareRx (PDP) Web site.

^† Per GEO Access analysis conducted in May of 2009. Currently there are approximately 266 preferred pharmacies in the network in New Mexico.

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Last updated 09/15/09 - S5715_WEB_NM_PDP
CMS Approved 11/19/2009