Blue MedicareRx (PDP)^SM: Medicare Part D Benefits Overview

Our Blue Medicare Rx (PDP) coverage offers three plans for you to choose from.

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, so you're 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 no 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: $33.30

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: $39.00

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: $67.50

 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 2,689 preferred pharmacies in the network in Texas.

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Last updated 09/15/09 - S5715_WEB_TX_PDP
CMS Approved 11/19/2009