Every Blue Advantage (HMO) and Blue Advantage (PPO) plan includes generous Part D prescription drug coverage to help with the costs of your medications.
The amount you pay depends on which drug tier your drug is in under your plan. The chart below explains what you can expect to pay for drugs in each tier in the Initial Coverage Stage.
Blue Advantage (HMO) Prescription Drug Benefits* |
|||
|---|---|---|---|
| Deductible | $0 prescription drug deductible | ||
| Preferred Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $3 copay | $6 copay | $0 copay |
| Tier 2 (Generics) | $12 copay | $24 copay | $36 copay |
| Tier 3 (Preferred Brand) | $45 copay | $90 copay | $135 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 33% coinsurance | Not Offered | Not Offered |
| Standard Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $10 copay | $20 copay | $30 copay |
| Tier 2 (Generics) | $18 copay | $36 copay | $54 copay |
| Tier 3 (Preferred Brand) | $47 copay | $94 copay | $141 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 33% coinsurance | Not Offered | Not Offered |
*For in-network pharmacies only
Premium Blue Advantage (PPO) Prescription Drug Benefits* |
|||
|---|---|---|---|
| Deductible | $0 prescription drug deductible | ||
| Preferred Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $3 copay | $6 copay | $0 copay |
| Tier 2 (Generics) | $12 copay | $24 copay | $36 copay |
| Tier 3 (Preferred Brand) | $45 copay | $90 copay | $135 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 33% coinsurance | Not Offered | Not Offered |
| Standard Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $10 copay | $20 copay | $30 copay |
| Tier 2 (Generics) | $18 copay | $36 copay | $54 copay |
| Tier 3 (Preferred Brand) | $47 copay | $94 copay | $141 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 33% coinsurance | Not Offered | Not Offered |
*For in-network pharmacies only
For our PPO plans, If you use an out-of-network provider, your share of the costs for your covered services may be higher. Out-of-network/non- contracted providers are under no obligation to treat Blue Advantage members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
$0 Blue Advantage (PPO) Prescription Drug Benefits* |
|||
|---|---|---|---|
| Deductible | $195 prescription drug deductible, applies to drugs in Tiers 3-5 | ||
| Preferred Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $3 copay | $6 copay | $0 copay |
| Tier 2 (Generics) | $12 copay | $24 copay | $36 copay |
| Tier 3 (Preferred Brand) | $45 copay | $90 copay | $135 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 29% coinsurance | Not Offered | Not Offered |
| Standard Retail and Mail-Order Cost Sharing | |||
| Tier | One-Month Supply | Two-Month Supply | Three-Month Supply |
| Tier 1 (Preferred Generics) | $10 copay | $20 copay | $30 copay |
| Tier 2 (Generics) | $18 copay | $36 copay | $54 copay |
| Tier 3 (Preferred Brand) | $47 copay | $94 copay | $141 copay |
| Tier 4 (Non-Preferred Drug) | $100 copay | $200 copay | $300 copay |
| Tier 5 (Specialty) | 29% coinsurance | Not Offered | Not Offered |
*For in-network pharmacies only
For our PPO plans, If you use an out-of-network provider, your share of the costs for your covered services may be higher. Out-of-network/non- contracted providers are under no obligation to treat Blue Advantage members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
Download the Blue Advantage Formulary (Updated 10/15/2021) to search our list of covered drugs, see the tier and if there are any requirements for coverage. Check multiple medications and estimate your annual drug costs by using our Find & Price Prescription Drugs tool.
Blue Advantage members have options on where and how to get their medicines:
It is important to remember that enrolling in Blue Advantage does not affect Medicare coverage for any drugs that may be covered under Medicare Part A or Part B. If you meet Medicare coverage requirements, your drugs will still be covered under Medicare Part A or Part B even though you are enrolled in Blue Advantage.
Get 200 credits a year, equal to a retail value of $200, for over-the-counter (OTC) supplies. This includes pain relievers, first aid, vitamins, personal care items and more! You'll receive a catalog to order up to 50 credits worth of OTC items online or by phone every quarter. Click below to view the catalog.
Your Blue Advantage plan comes with both preventive and basic dental services.
Preventive services at $0 copay include:
Basic services covered at 50% coinsurance include:
Coverage is limited to $1,000 per year, for all dental services combined, preventive and basic.
To find a Blue Advantage dental provider, call 1-866-215-2357 (TTY 711) or click on the button below.
Your Blue Advantage plan comes with routine vision benefits for an annual eye examination as well as lenses and eyewear.
Your vision benefit covers one routine eye exam and one pair of eyeglass lenses or contact lenses each calendar year, as long as they are purchased from an in-network routine vision care provider. It also covers $130 toward the cost of eyeglass frames or contact lenses.
Find a Vision ProviderYour Blue Advantage plan comes with online medical and behavioral health visits through BlueCare, which lets you have visits from your computer, smartphone, tablet or any device with internet and a camera.
Blue Care medical visits have a $0 copay when you sign in as a Blue Advantage member and can be used 24/7 for minor, non-emergency illnesses such as fever, flu symptoms, cold or cough, and sinus infections.
With BlueCare for behavioral health, you can schedule a visit with a psychology or psychiatry provider for a $40 copay to discuss depression, grief, stress, life transitions and more.
You can also use BlueCare to get a prescription or to check in with a doctor if you need a follow-up visit.
As a Blue Advantage member, you can enjoy the Silver&Fit® Healthy Aging and Fitness program at no additional cost beyond your monthly premium. Or for an additional buy-up price, you can join a Premium location.
The Silver&Fit program gives you the digital tools and personalized support you need to enjoy a better life balance.
Start your healthy aging journey with:
Silver&Fit is provided by American Specialty Health Fitness, Inc. a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a federally registered trademark of ASH. American Specialty Health Fitness, Inc. is an independent company that administers fitness benefits for Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Louisiana HMO.
As a Blue Advantage member, you can get up to $50 per year in gift cards (digital and physical gift cards from national and local retailers) for completing approved health actions.
You could be rewarded for the first two health actions you choose to complete from the list below:
Blue365 is a free health and wellness discount program offered to members of the Blue Cross System. Get year-round discounts on fitness gear, healthy eating options and more with exclusive member savings from more than 70 partners.
Click below to search for Hospitals or Medical Providers in the Vantage Network.
