BlueRx Essential (PDP): 2027 benefits and costs

2027 benefit summary

Compare prescription costs by drug tier, pharmacy type and fill length. A copay is a fixed dollar amount; coinsurance is a percentage of the covered cost. When both are listed, check when each applies. A range depends on the prescription and plan rules.

Prescription drug coverage

Your drug cost depends on the medication, its tier, the pharmacy and how many days you fill. These are initial-coverage costs, not a quote for a particular prescription.

Find your medicine’s tier, then read across to its fill length. Each amount is for one prescription fill at the named pharmacy type. “Not listed” means the price is not summarized here, not that it is free or not covered.

Standard retail costs

Mail-order and other pharmacies

The following tables use the same tier-and-fill layout, with each pharmacy type kept separate. Out-of-network pharmacy use is subject to the plan’s coverage rules and can cost more than the amounts listed.

Out-of-network pricing: You pay the standard retail copay or coinsurance, plus any difference between the pharmacy’s billed charge and the amount the plan allows at a standard retail pharmacy.

Standard mail order costs

Long-term care pharmacy costs

Out-of-network pharmacy costs

Drug coverage rules and exceptions

Check that your medicine is on the plan’s list of covered drugs (formulary). Quantity limits, step therapy, approval requirements and Extra Help can affect your costs.

Tier 1: Preferred Generic

Drugs included in this tier

Part D Drugs Only

Longer fills available for every covered drug

Yes

Some longer-fill prescriptions require a one-month first fill

No

Tier 2: Generic

Drugs included in this tier

Part D Drugs Only

Longer fills available for every covered drug

Yes

Some longer-fill prescriptions require a one-month first fill

No

Tier 3: Preferred Brand

Drugs included in this tier

Part D Drugs Only

Longer fills available for every covered drug

Yes

Some longer-fill prescriptions require a one-month first fill

No

Tier 4: Non-Preferred Drug

Drugs included in this tier

Part D Drugs Only

Longer fills available for every covered drug

Yes

Some longer-fill prescriptions require a one-month first fill

No

Tier 5: Specialty Tier

Drugs included in this tier

Part D Drugs Only

Covered insulin and certain recommended adult vaccines have special cost protections. Confirm how those rules apply to your prescription with Medicare or the plan.