2023 Medicare HMO Blue FlexRx
Prescriptions
Understand Plan Features
Medicare Advantage Pharmacy Network & Formulary
Our Pharmacy and Therapeutics Committee frequently reviews the list of covered medications for safety and effectiveness. To learn more about this process, our formulary, or why changes to the formulary might be made, visit this section.
Important Documents: Prescription Drug Coverage
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However, you can choose a Medicare Supplement and Prescription Drug plan.
Prescription Drug Coverage Summary
Prescription Drug Coverage |
Cost |
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Annual Deductible |
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Initial Coverage |
Preferred Cost-Sharing Pharmacies |
Standard Cost-Sharing Pharmacies |
CVS Caremark Mail Service |
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Tier 1: Preferred Generic |
$0 copay |
$6 copay |
$0 copay |
Tier 2: Generic |
$5 copay |
$10 copay |
$10 copay |
Tier 3: Preferred Brand |
$42 copay |
$47 copay |
$84 copay |
Tier 4: Non-Preferred Drug |
$95 copay |
$100 copay |
$190 copay |
Tier 5: Specialty Drugs |
28% of the cost |
28% of the cost |
not available at 90-day supply |
Coverage Gap |
After your total yearly drug costs reach $4,660, you receive limited coverage by the plan on certain drugs. For covered generics, you pay 25% of the plan's costs. For covered brand drugs, you pay no more than 25% of the plan's costs (excluding dispensing fees). |
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Catastrophic Coverage |
After your yearly out-of-pocket drug costs reach $7,400, you pay the greater of:
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CVS Caremark, an independent company that administers your pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts.
Pharmacy Directory
There are over 1,000 pharmacies in our Massachusetts network and over 59,000 pharmacies in our nationwide network. We contract with pharmacies that equal or exceed regulatory requirements for pharmacy access in your area.
Find a Pharmacy Near You
- Use our online pharmacy search tool
- Download the pharmacy directory: 2023 Medicare Advantage Pharmacy Directory
We may periodically make changes to the comprehensive formulary (covered drug list). If we remove a medication from the formulary, affected members will be notified in writing before the change is made.
Learn More
Compare 2023 Medicare Plans
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Other Medicare Plans
- Your monthly premium will be different if you qualify for Extra Help from Medicare.
- This information is not a complete description of benefits. Call 1-800-200-4255 (TTY: 711) for more information.
- Every year, Medicare evaluates plans based on a 5-star rating system.