BlueMedicare PPO - Florida Blue

Benefit Original Medicare BlueMedicare PPO29. Prescription Drugs • Most drugs are not covered under OriginalMedicare. You can add prescription drugcoverage to Original Medicare by joining aMedicare Prescription Drug Plan, or you canget all your Medicare coverage, includingprescription drug coverage, by joining aMedicare Advantage Plan or a Medicare CostPlan that offers prescription drug coverage.Drugs Covered under Medicare Part BGeneral• 20% of the cost for Part B-covered drugs (notincluding Part B-covered chemotherapydrugs).• 20% of the cost for Part B-coveredchemotherapy drugs.Drugs Covered under Medicare Part DGeneral• This plan uses a formulary. The plan will sendyou the formulary. You can also see theformulary at www.myrxassistant.com on theweb.• Different out-of-pocket costs may apply forpeople who- have limited incomes,- live in long-term care facilities or- have access to Indian/Tribal/Urban (IndianHealth Service).• The plan offers national in-networkprescription coverage (i.e., this would include50 states and D.C.). This means that you willpay the same cost-sharing amount for yourprescription drugs if you get them at an innetworkpharmacy outside of the plan’sservice area (for instance, when you travel).13