MII Life, Inc., a Medicare contractor, is an independent licensee of the Blue Cross® and Blue Shield® Association and the underwriter for Basic Blue® Rx, a prescription drug plan. Enrollment in Basic Blue Rx depends on contract renewal. Each Blue Cross and/or Blue Shield plan is an independent licensee of the Blue Cross and Blue Shield Association.
Medicare beneficiaries may also enroll in Basic Blue® Rx through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Drug pricing information on this website is intended as an educational tool and is not a promise as to the price we will offer in the future. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. This information is not a complete description of benefits. Contact the plan for more information. Other pharmacies are available in our network. Medicare has neither reviewed nor endorsed this information. For a variety of reasons (e.g., because you visit an out-of-network pharmacy), actual pricing may vary. You must continue to pay your Medicare Part B premium. This is not a complete list of drugs covered by our plan. For a complete listing, please call TTY 1-877-376-2185 TTY 711 or visit www.basicbluerx.com The formulary and pharmacy network may change at any time. You will receive notice when necessary. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800- MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, 7 days a week or consult www.medicare.gov.
S6986_092617_B01_ALL ALL CMS Approved 10/3/2017
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