Horizon Medicare Blue Rx Standard (PDP)

S5993 - 001 - 0
4 out of 5 stars (4 / 5)

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Horizon Medicare Blue Rx Standard (PDP) is a Medicare Part D Prescription Drug Plan by Horizon Blue Cross Blue Shield of New Jersey.

This page features plan details for 2023 Horizon Medicare Blue Rx Standard (PDP) S5993 – 001 – 0.

IMPORTANT: This page has been updated with plan and premium data for the 2023.

Locations

Horizon Medicare Blue Rx Standard (PDP) is offered in the following locations.

Plan Overview

Horizon Medicare Blue Rx Standard (PDP) offers the following coverage and cost-sharing.

Insurer: Horizon Blue Cross Blue Shield of New Jersey
Drugs Covered: Yes

Ready to sign up for Horizon Medicare Blue Rx Standard (PDP) ?

Get help from a licensed Medicare agent.

Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.

Drug Info

Horizon Medicare Blue Rx Standard (PDP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $505.00
Initial Coverage Limit: $4,660.00
Catastrophic Coverage Limit: $7,400.00
Drug Benefit Type: Actuarially Equivalent Standard
Gap Coverage: Yes
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
$68.60 $59.80 $51.10 $42.30 $33.60

Initial Coverage Phase

After you pay your $505.00 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 $4,660.00. Once you reach that amount, you will enter the next coverage phase.

Gap Coverage Phase

After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.

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 $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

Drug TypeCost Share
Generic drugs$4.15 copay or 5% (whichever costs more)
Brand-name drugs$10.35 copay or 5% (whichever costs more)

Ready to sign up for Horizon Medicare Blue Rx Standard (PDP) ?

Get help from a licensed Medicare agent.

Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.

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