Blue Shield Rx Plus A 2026 Medicare Part D Plan Available in California
Blue Shield Rx Plus A 2026 Medicare Part D Plan Available in California
This guide provides an overview of the Blue Shield Rx Plus Medicare Part D plan for 2025. You’ll find important information about the plan's benefits, costs, and star rating, along with details on how to enroll in California. Use the sections below to explore your prescription drug coverage options.
Blue Shield Rx Plus helps lower your prescription drug expenses, whether you’re enrolled in Medicare Part A and/or Part B, or a Medicare Advantage plan without drug coverage in California.
| Blue Shield Rx Plus: Part D Plan Overview | |
|---|---|
| Part D Plan ID: | S2468-003 |
| Plan Year: | 2026 |
| Total Part D Premium: | $199.70 |
| Annual Deductible: | $615.00 |
| Part D Benefit Type: | Basic |
| No Deductible Drug Tier: | No |
| Low Income Subsidy: | Yes |
| Insured By: | Blue Shield of California |
| We're Here to Help You Enroll |
|---|
Understanding Medicare Part D Plan Costs
Blue Shield Rx Plus has a range of costs, including monthly premiums, deductibles, copayments, and coinsurance. Understanding how each of these components impacts your overall expenses is key to managing your prescription drug costs effectively. The sections below will guide you through each cost factor.
Premium Breakdown
The Blue Shield Rx Plus plan's monthly premium is an important factor in your total costs. Some plans include extra fees or offer financial aid through the Low-Income Subsidy (LIS) program. The following table details the premium costs for this 2026 plan by Blue Shield of California.
| Basic Part D Premium: | $199.70 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $199.70 |
| Low Income Premium Subsidy: | $12.00 |
| Low Income Premium Subsidy CMS Pays: | $12.00 |
| Low Income Subsidy Premium: | $187.70 |
TIP: To learn more about the Low-Income Subsidy (LIS) program, also known as "Extra Help," and how it can assist with your prescription drug costs in California, visit the Social Security Extra Help page.
Annual Deductible Information
This plan has a Medicare Part D annual deductible of $615.00. You must pay this amount upfront at the pharmacy before Blue Shield of California begins contributing to your prescription costs.
Out-of-Pocket Expenses with this Part D Plan
In addition to the monthly premium and deductible, you'll also be responsible for copayments (fixed amounts) and/or coinsurance (a percentage of the drug cost) under the Blue Shield Rx Plus plan. The following table details these out-of-pocket costs.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic* | $3.00 | $0.00 | |
| Generic | $14.00 | $0.00 | |
| Preferred Brand | 18.00% | 0.00% | |
| Non-Preferred Drug | 47.00% | 0.00% | |
| Specialty Tier | 25.00% | 25.00% | |
| *Deductible does not apply. | |||
How the CMS 5-Star Rating Works
The CMS evaluates Medicare Part D plans each year and assigns a star rating from 1 to 5 based on their overall quality and performance. These ratings are determined by factors like member experiences, customer service, and how well the plan ensures prescription drug safety. Higher ratings indicate better quality, making it easier for you to choose the right plan. Below is the star rating for the Blue Shield Rx Plus plan.
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
When to Enroll in Medicare Part D
Knowing when to enroll in a Medicare Part D plan is crucial to ensuring you have the coverage you need. Below are the main enrollment periods:
- Initial Enrollment Period (IEP): This seven-month period begins three months before your 65th birthday month. Discover more about your Medicare Initial Enrollment Period.
- Annual Enrollment Period (AEP): Every year between October 15 and December 7, you can make changes to your Medicare Part D plan. Learn about the Annual Enrollment Period.
- Medicare Advantage Open Enrollment Period (MA-OEP): From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare, , so long as you are currently enrolled in a Medicare Advantage plan. Learn more about the MA Open Enrollment Period.
- Special Enrollment Period (SEP): Life events such as relocating or losing coverage can trigger a Special Enrollment Period, allowing changes outside the usual enrollment windows.
How to Enroll in Medicare Part D
Ready to enroll in Blue Shield Rx Plus or another Medicare Part D plan? Here are your options:
- Online via MedicareEnrollment.com: Compare and get enrolled online by visiting MedicareEnrollment.com.
- Call HealthCompare: Speak with a licensed insurance agent by calling HealthCompare at 833-748-3201 (TTY 711) for personalized assistance (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
- Call 1-800-MEDICARE: You can also call 1-800-MEDICARE (1-800-633-4227) for help with enrollment. TTY users should dial 1-877-486-2048.
- Call the Plan Directly: Contact the plan directly using the information provided below to enroll by phone.
Contact Blue Shield of California
| Website: | Blue Shield of California Plan Page |
|---|---|
| Formulary: | Blue Shield of California Formulary Page |
| Pharmacy: | Blue Shield of California Pharmacy Page |
| Prospective Part D Members: | (888)292-7591 |
| Prospective Part D TTY Users: | 711 |
Plans Offered Through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint
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