Blue Cross and Blue Shield of IL, NM, OK, TX
Blue Cross MedicareRx Value (PDP)
Medicare plan ID S5715-005-000 · 2026 benefits. Every benefit the plan filed with Medicare, from the same data as the comparison grid. Other years: 2026 · 2027
| Benefit | Blue Cross MedicareRx Value (PDP) |
|---|---|
| The plan What the plan costs before any drug is dispensed. | |
| Monthly premium | $167.40/mo |
| Yearly drug deductible | $615Applies to tiers 3, 4, 5 |
| Star rating (2026) | 2.0 out of 5 |
| Drugs on the plan's list | 3,464 |
| 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: $0 preferred · $5 standard$0 for 3 months by mail |
| Tier 2 | Generic: $1 preferred · $6 standard$3 for 3 months by mail |
| Tier 3 | Preferred Brand: 18% preferred · 21% standard18% for 3 months by mail |
| Tier 4 | Non-Preferred Drug: 32% preferred · 34% 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.