Blue Cross MedicareRx (PDP)SM Plans | Blue Cross and Blue Shield of Texas

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Welcome to Blue Cross MedicareRx (PDP)

Whether you’re new to Medicare or just to your plan, here are some tips to make the transition smooth. Feeling a little nervous about your new plan? We understand. Your Medicare plan may be new to you now, but soon you’ll get to know and be comfortable with it. You may even like it better. We hope to answer your basic questions here.

If you need more information or just want a little help understanding your benefits or the Medicare rules, call the number listed on the back of your member ID card.

We Stay in Touch

Because we care about your well-being and want you to get the most from your Medicare plan, we stay in touch with you throughout the year.


We’d like to have your email address to send you communications about plan benefits and programs throughout the year. We never share your email address outside the plan. You can always opt out or ask us to stop sending you emails.

Annual Notice of Change (ANOC)

You will receive an Annual Notice of Change in October. This notice outlines any expected premium/benefit changes (if any) for the next year. These changes will begin January 1 of the following calendar year. Review this document carefully.

Explanation of Benefits (EOB)

You will receive a statement called the Explanation of Benefits. How often you receive it depends on how often you fill your prescriptions. This statement is not a bill. It simply details what you have paid and indicates the level benefits you’ve used. Review these to be sure they are correct. If you think there are errors, call customer service. If you think you are the victim of fraud, report it immediately.

The Drug Formulary May Be Different

Blue Cross MedicareRx covers a broad range of prescription drugs. The formulary may be different from what you’re used to and it can change. The most current formulary is always available online. Share the formulary with your doctor, and talk about the drugs you take now. You may be able to save money by choosing generic drugs. Ask if this is an option for you.

Drugs Are Placed Into Tiers

In prescription drug plans, drugs are placed into tiers. The costs for drugs in each tier are different. Generally, drugs on lower-number tiers cost less. The tiers are:

  • Tier 1 Preferred Generic Drugs
  • Tier 2 Generic Drugs
  • Tier 3 Preferred Brand Drugs
  • Tier 4 Non-Preferred Drug (applies to Blue Cross MedicareRx Basic (PDP))
  • Tier 4 Non-Preferred Brand Drugs (applies to Blue Cross MedicareRx Value (PDP)SM and Blue Cross MedicareRx Plus (PDP)SM)
  • Tier 5 Specialty Drugs

Prior Authorization, Step Therapy and Quantity Limits

Some drugs have requirements or limits on coverage. But there can be exceptions to these rules. Please read the formulary for information about these rules and the exceptions.

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