How to determine your drug cost
|It can be challenge to estimate your prescription drug cost. MedicareBlue Rx has provided instructions to help you determine your drug cost.|
Medicare Part D, also called the Medicare prescription drug benefit, is an optional benefit to help Medicare beneficiaries pay for prescription drugs. The State has a Medicare Part D plan, Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%) available to Medicare-eligible State retirees. Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%) is available with:
- Iowa Choice
- National Choice
- Group Program F
- Group Program N
Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%) Summary
Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%) with Iowa Choice or National Choice
Pharmacy Coverage with Group Program F or Group Program N
Group MedicareBlue Rx Iowa Customer Service
Extra Help to Pay Prescription Drug Premiums and Costs
For More Information
Iowa Group MedicareBlue Rx Resources
- The plan does not have a deductible. You have first dollar coverage.
- The plan has five formulary tiers.
- Your cost for prescriptions on Tier 1: Preferred Generic and Tier 2: Non-Preferred Generic are a copay. $5 copay for Tier 1 and $10 copay for Tier 2.
- Tiers 3 and 4 are brand name drugs. Your cost for prescriptions on Tiers 3 – 5 is coinsurance.
- Tier 5 are specialty drugs. Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like cancer, rheumatoid arthritis, and multiple sclerosis. Specialty drugs sometimes require special handling and administration (typically injection or infusion), and patients using a specialty drug may need careful oversight from a health care provider who can watch for side effects and ensure that the medication is working as intended. Your cost for specialty drugs is a coinsurance of 33 percent.
The 2021 premium is $98.90 per month*.
*Since January 1, 2011, higher-income beneficiaries will pay an additional amount to Social Security/Medicare for Medicare Part D coverage.
If you are eligible for Medicare and choose Iowa Choice or National Choice, you can significantly reduce your Wellmark premium for either option by enrolling in Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%).
Iowa Group MedicareBlue Rx and Wellmark will work together for your prescription needs. Enrollment in the Iowa Group MedicareBlue Rx plan significantly reduces the amount Wellmark pays for prescription drug coverage. These savings are passed along to you in the form of lower premiums for your Iowa Choice or National Choice health coverage.
You will have two ID cards - Group MedicareBlue Rx and Wellmark. You will use the Group MedicareBlue Rx ID card in addition to your Wellmark ID card at the pharmacy. You must show both of these identification cards at the pharmacy for claims to be filed correctly. Tell your pharmacist to file your claim under the Group MedicareBlue Rx card first, and then under your State of Iowa Wellmark plan card. Under the coordinated pharmacy benefits, Group MedicareBlue Rx will pay your claims as primary and the State of Iowa's Wellmark plan will pay as secondary. You need to make sure your pharmacy files your claims this way in order to receive the correct State of Iowa plan copayments.
|Important information regarding Iowa Group MedicareBlue Rx:
If you are enrolled in Group Program F or Group Program N, you may:
- Maintain coverage with the Iowa Group MedicareBlue Rx, OR
- Elect an individual Medicare Prescription Drug Program from an insurance company offering a Medicare Part D program in your state.
If you elect an Individual Medicare Part D plan, you can return to Iowa Group MedicareBlue Rx during the next Enrollment and Change period.
Once you are enrolled in Group MedicareBlue Rx, you can can contact their customer service area at 877.838.3827 (toll-free) with any questions you may have.
|You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:
24 hours a day, 7 days a week
Social Security Administration
Your State Medicaid Office
Contact the Department of Administrative Services, Human Resources Enterprise at 866.895.2464 or email email@example.com if you have any questions or need additional information.
The Department of Administrative Services – Human Resources Enterprise is providing this information about the State of Iowa’s benefits. The information on this web page is subject to change. Nothing herein shall be construed as a guarantee of benefits. This webpage is not a complete description of the State of Iowa’s benefit plans. Nothing on this web page supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements. If the wording in this web page contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern.