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
Blue Advantage (HMO) Give Back Plan 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
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 12/01/2023) 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.
Enjoy $925 for the year on your personal prepaid Blue Advantage Flex Card. Use your card balances at participating retailers. Get your over-the-counter supplies by retail, online or phone—whatever you choose.
Your Flex Card helps pay for out-of-pocket costs, including:
Get $200 a year ($50 each quarter) on your flex card to spend on over-the-counter supplies at participating retail locations. You can also order online or by phone for home delivery.
Your Blue Advantage plan comes with both preventive and basic dental services covered, in-network, at no cost to you.
Preventive services include:
Basic services include:
Out of network services are at a 50% coinsurance. Coverage is limited to $1,200 per year, for all dental services combined.
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 with the freedom to choose from hundreds of participating providers and retailers. Your vision benefit covers one annual eye examination as well as $225 on your flex card to pay for eyewear such as contact lenses or glasses.
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 Exercise program at no additional cost beyond your monthly premium.
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.
Participating facilities and fitness chains may vary by location and are subject to change.
Kits and rewards are subject to change.
Please talk to your doctor before starting or changing your exercise routine.
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 eligible health actions you choose to complete from the list below:
Members must register by Dec. 31 to redeem rewards for health actions taken within that plan year.
Click below to search for Hospitals or Medical Providers in the Vantage Network.
