2027 Medicare Part D prescription drug plan
Prescription Blue Select (PDP): 2027 benefits and costs
Blue Cross Blue Shield of Michigan PDP
CMS plan ID: S5584-001-0 · Plan year: 2027
Prescription Blue Select (PDP) is a 2027 Medicare Part D prescription drug plan offered by Blue Cross Blue Shield of Michigan. It is listed in Michigan.
2027 plan costs at a glance
- Organization
- Blue Cross Blue Shield of Michigan
- Plan organization
- BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY
- Parent company
- Blue Cross Blue Shield of Michigan Mutual Ins. Co.
- Plan type
- PDP
- Part D premium
- $49.80
- 2027 CMS Star Rating
2027 benefit summary
Prescription drug coverage
Costs shown are for initial coverage.
Drug deductible exceptions: Tier 1 are exempt from the deductible.
Preferred retail costs
On a small screen, scroll the table sideways to compare all fill lengths.
| Drug tier | 31 days | 90 days | 100 days |
|---|---|---|---|
| Tier 1Preferred Generic | $2.00 | Not listed | $6.00 |
| Tier 2Generic | $5.00 | $15.00 | Not listed |
| Tier 3Preferred Brand | 23% | 23% | Not listed |
| Tier 4Non-Preferred Drug | 25% | 25% | Not listed |
| Tier 5Specialty Tier | 25% | Not listed | Not listed |
Standard retail costs
On a small screen, scroll the table sideways to compare all fill lengths.
| Drug tier | 31 days | 90 days | 100 days |
|---|---|---|---|
| Tier 1Preferred Generic | $7.00 | Not listed | $21.00 |
| Tier 2Generic | $10.00 | $30.00 | Not listed |
| Tier 3Preferred Brand | 23% | 23% | Not listed |
| Tier 4Non-Preferred Drug | 25% | 25% | Not listed |
| Tier 5Specialty Tier | 25% | Not listed | Not listed |
Mail-order and other pharmacies
Out-of-network pricing: The standard retail copay or coinsurance applies, without an added difference between the billed charge and the plan’s allowed amount. The plan’s out-of-network coverage rules still apply.
Preferred mail order costs
On a small screen, scroll the table sideways to compare all fill lengths.
| Drug tier | 31 days | 90 days | 100 days |
|---|---|---|---|
| Tier 1Preferred Generic | $2.00 | Not listed | $6.00 |
| Tier 2Generic | $5.00 | $15.00 | Not listed |
| Tier 3Preferred Brand | 23% | 23% | Not listed |
| Tier 4Non-Preferred Drug | 25% | 25% | Not listed |
| Tier 5Specialty Tier | 25% | Not listed | Not listed |
Standard mail order costs
On a small screen, scroll the table sideways to compare all fill lengths.
| Drug tier | 31 days | 90 days | 100 days |
|---|---|---|---|
| Tier 1Preferred Generic | $7.00 | Not listed | $21.00 |
| Tier 2Generic | $10.00 | $30.00 | Not listed |
| Tier 3Preferred Brand | 23% | 23% | Not listed |
| Tier 4Non-Preferred Drug | 25% | 25% | Not listed |
| Tier 5Specialty Tier | 25% | Not listed | Not listed |
Long-term care pharmacy costs
| Drug tier | 31 days |
|---|---|
| Tier 1Preferred Generic | $7.00 |
| Tier 2Generic | $10.00 |
| Tier 3Preferred Brand | 23% |
| Tier 4Non-Preferred Drug | 25% |
| Tier 5Specialty Tier | 25% |
Out-of-network pharmacy costs
| Drug tier | 31 days |
|---|---|
| Tier 1Preferred Generic | $7.00 |
| Tier 2Generic | $10.00 |
| Tier 3Preferred Brand | 23% |
| Tier 4Non-Preferred Drug | 25% |
| Tier 5Specialty Tier | 25% |
Drug coverage rules and exceptions
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
- Initial-coverage prices also apply to drugs exempt from the deductible
- Yes
Special cost protections apply to covered insulin and recommended adult vaccines.
Where this plan is offered
CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.