Blue Shield Rx Enhanced (PDP)
S2468 - 004
(3.5 / 5)
Blue Shield Rx Enhanced (PDP) is a Medicare Part D Prescription Drug Plan by Blue Shield of California.
This page features plan details for 2022 Blue Shield Rx Enhanced (PDP) S2468 – 004.
Locations
Blue Shield Rx Enhanced (PDP) is offered in the following locations.
Plan Overview
Blue Shield Rx Enhanced (PDP) offers the following coverage and cost-sharing.
| Insurer: | Blue Shield of California |
| Drugs Covered: | Yes |
Ready to sign up for Blue Shield Rx Enhanced (PDP) ?
Drug Info
Blue Shield Rx Enhanced (PDP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $0.00 |
| Initial Coverage Limit: | $4430 |
| Catastrophic Coverage Limit: | $7050 |
| Drug Benefit Type: | Enhanced |
| Gap Coverage: | No |
| Formulary Link: | Formulary Link |
Part D Premium Reduction
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs. The table below shows how the LIS impacts the Part D premium of this plan.| Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
| $160.20 | $151.90 | $143.60 | $135.30 | $127.00 |
Initial Coverage Phase
After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4430. Once you reach that amount, you will enter the next coverage phase.
30 Day
60 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $2.00 copay | $11.00 copay | ||
| 2 (Generic) | $7.00 copay | $14.00 copay | ||
| 3 (Preferred Brand) | $43.00 copay | $47.00 copay | ||
| 4 (Non-Preferred Drug) | 31% | 33% | ||
| 5 (Specialty Tier) | 33% | 33% | 33% |
60 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | ||||
| 2 (Generic) | ||||
| 3 (Preferred Brand) | ||||
| 4 (Non-Preferred Drug) | ||||
| 5 (Specialty Tier) |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $4.00 copay | $33.00 copay | $4.00 copay | |
| 2 (Generic) | $14.00 copay | $42.00 copay | $14.00 copay | |
| 3 (Preferred Brand) | $86.00 copay | $141.00 copay | $86.00 copay | |
| 4 (Non-Preferred Drug) | 31% | 33% | 31% | |
| 5 (Specialty Tier) |
Gap Coverage Phase
After your total drug costs (including what this plan has paid and what you have paid) reach $4430, you will pay no more than the amounts below for any drug tier until you reach $7050.
30 Day
90 Day
30 Day
90 Day
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7050, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
| Drug Type | Cost Share |
|---|---|
| Generic drugs | $3.95 copay or 5% (whichever costs more) |
| Brand-name drugs | $9.85 copay or 5% (whichever costs more) |
Ready to sign up for Blue Shield Rx Enhanced (PDP) ?