Blue Cross and Blue Shield of North Carolina
Blue Medicare Rx Standard (PDP)
Medicare plan ID S5540-002-000 · 2026 benefits. Every benefit the plan filed with Medicare, from the same data as the comparison grid. Other years: 2026 · 2027
| Benefit | Blue Medicare Rx Standard (PDP) |
|---|---|
| The plan What the plan costs before any drug is dispensed. | |
| Monthly premium | $83.90/mo |
| Yearly drug deductible | $615Applies to tiers 2, 3, 4, 5 |
| Star rating (2026) | 3.0 out of 5 |
| Drugs on the plan's list | 3,013 |
| After the yearly cap | $0 for covered drugs |
| Every tier What each tier costs in the initial coverage phase, at a one-month supply and a three-month supply. | |
| Tier 1 | Preferred Generic: $5 preferred · $15 standard$15 for 3 months by mail |
| Tier 2 | Generic: $10 preferred · $20 standard$30 for 3 months by mail |
| Tier 3 | Preferred Brand: 20% preferred · 20% standard20% for 3 months by mail |
| Tier 4 | Non-Preferred Drug: 32% preferred · 32% standard32% for 3 months by mail |
| Tier 5 (specialty) | Specialty Tier: 25% preferred · 25% standard |
Add your drugs on the plan list to see how this plan covers them. Figures are what the plan filed with Medicare for 2026; check the plan's Evidence of Coverage before you enroll.