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How To Get Prescription Coverage Under Medicare

Though prescription drug coverage is not included in Original Medicare, there are ways to cover the cost of your medications.  Two options available through BlueCross that include prescription coverage include:

Option 1: A Stand-Alone Medicare Part D prescription drug plan, best for people with Original Medicare

Option 2: A Medicare Advantage plan with included drug coverage

Part D Plans

If you have Original Medicare, not Medicare Advantage, you'll want to look into Part D plans.

Part D prescription drug plans help people with Original Medicare (Parts A + B) to more easily afford prescription drugs. It's a separate drug plan that you purchase in addition to Original Medicare. This coverage can help reduce your costs for medications and is available only from private companies like BlueCross BlueShield.

How Stand-Alone Prescription Drug Plans Work

You’ll usually pay a portion of the cost for your covered medication and your plan will pay the rest. Part D plans have a monthly plan premium and some may also have a deductible — an amount you will have to pay before your cost sharing starts. Part D plans have a list of covered drugs called a formulary and a network of participating pharmacies.

See Part D Plans

Medicare Advantage Plans

Medicare Advantage (Part C) plans offer a simple way to roll prescription coverage into your health insurance plan. Medicare Advantage combines Hospital (Part A), Medical (Part B), and Prescriptions (Part D) into one package. This option offers predictable out-of-pocket costs with low monthly plan premiums.

How Medicare Advantage Works

With a Medicare Advantage plan, you will receive coverage for all Part A & B covered services. Most Medicare Advantage plans also include Part D drug coverage. You can only get Medicare Advantage plans from private insurance companies like BlueCross BlueShield. You'll have the option to choose from different kinds of Medicare Advantage plans that include various Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) options. 

See Medicare Advantage Plans

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Disclaimer

Last Updated: October 1, 2024

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BlueCross BlueShield of South Carolina is a Medicare Advantage PPO plan with a Medicare contract. BlueCross Rx Value is a stand-alone prescription drug plan with a Medicare contract. Enrollment in BlueCross Total, BlueCross Total Value, BlueCross Blue Basic, or BlueCross Rx Value depends on contract renewal. 

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. 

Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of South Carolina Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call Customer Service or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. 

BlueCross BlueShield of South Carolina does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in our health plans, when we enroll members or provide benefits. Free language interpretation services are available for those who cannot read or speak English.