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If you are an Individual or Family Member under age 65, please register here.

If you are an Medicare or Medicare Supplement member, please register here.

2014 Low Income Subsidy (LIS) Premium Information

Medicare provides “Extra Help” to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you get help paying for any Medicare drug plan;s monthly premium, yearly deductible and prescription copayments. In addition, your premium will generally be lower when you receive help. This Extra Help also counts toward your out-of-pocket costs.

People with limited income and resources may qualify for Extra Help. Some people automatically qualify for Extra Help and don't need to apply. Medicare mails a letter to people who automatically qualify for Extra Help.

If you think you may qualify for Extra Help, call Social Security at 1-800-772-1213, TTY users can call 1-800-325-0778. You may also be able to apply at your State Medicaid Office, call 1-800-926-2588, TTY users can call 1-208-332-7205. After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.

The premiums listed below are for medical services and prescirption drug benefits, but do not include any Part B premium you may have to pay.

True Blue Rx Option I HMO
Low-Income Subsidy

  True Blue Rx Option II HMO
Low-Income Subsidy
2013 2014   2013 2014
$0 deductible $0 deductible   $300 deductible $0 deductible
$0 deductible $0 deductible   $66 deductible $0 deductible
$1.10 for generics and brands that are treated as generics  $3.50 for brand name drugs $1.20 for generics and brands that are treated as generics  $3.60 for brand name drugs   $1.10 for generics and brands that are treated as generics  $3.50 for brand name drugs $1.20 for generics and brands that are treated as generics  $3.60 for brand name drugs
$2.65 for generics and brands that are treated as generics  $6.60 for brand name drugs $2.55 for generics and brands that are treated as generics  $6.35 for brand name drugs   $2.65 for generics and brands that are treated as generics  $6.60 for brand name drugs $2.55 for generics and brands that are treated as generics  $6.35 for brand name drugs
15% co-insurance for all drugs 15% coinsurance for all drugs   15% coinsurance for all drugs 15% coinsurance for all drugs
         
2014 Part D Premium
True Blue Rx Option I HMO
  2014 Part D Premium
True Blue Rx Option II HMO
Your level of extra help Monthly Premium for True Blue Plan 001   Your level of extra help Monthly Premium for True Blue Plan 010
100% $22.10   100% $0.00
75% $31.80   75% $7.10
50% $41.60   50% $14.30
25% $51.30   25% $21.40
         
True Blue Connected Care HMO-POS
Low-Income Subsidy
     
2013 2014      
  $0 deductible      
  $0 deductible      
  $1.20 for generics and brands that are treated as generics  $3.60 for brand name drugs      
  $2.55 for generics and brands that are treated as generics  $6.35 for brand name drugs      
  15% coinsurance for all drugs      
         
2014 Part D Premium
True Blue Connected Care HMO-POS
   
Your level of extra help Monthly Premium for True Blue Plan 012      
100% $0.00      
75% $7.10      
50% $14.30      
25% $21.40      
         
         
Secure Blue Idaho PPO
Low-Income Subsidy
  Secure Blue Treasure Valley PPO
Low-Income Subsidy
 
2013 2014   2013 2014
$0 deductible $200 deductible   $0 deductible $200 deductible
$0 deductible $63 deductible   $0 deductible $63 deductible
$1.10 for generics and brands that are treated as generics  $3.50 for brand name drugs $1.20 for generics and brands that are treated as generics  $3.60 for brand name drugs   $1.10 for generics and brands that are treated as generics  $3.50 for brand name drugs $1.20 for generics and brands that are treated as generics  $3.60 for brand name drugs
$2.65 for generics and brands that are treated as generics  $6.60 for brand name drugs $2.55 for generics and brands that are treated as generics  $6.35 for brand name drugs   $2.65 for generics and brands that are treated as generics  $6.60 for brand name drugs $2.55 for generics and brands that are treated as generics  $6.35 for brand name drugs
15% coinsurance for all drugs 15% coinsurance for all drugs   15% coinsurance for all drugs 15% coinsurance for all drugs
         
2014 Part D Premium
Secure Blue Idaho PPO
  2014 Part D Premium
Secure Blue Treasure Valley PPO
Your level of extra help Monthly Premium for Secure Blue Plan 001   Your level of extra help Monthly Premium for Secure Blue Plan 006
100% $5.80   100% $8.10
75% $15.50   75% $17.80
50% $25.30   50% $27.60
25% $35.00   25% $37.30

2014 Tools, Resources & Other Information

Drug List (Formulary) & Prescription Drug Resources

Membership Information

Summary of Benefits

Evidence of Coverage

Annual Notice of Change

Other Plan and Benefit Information

Medicare beneficiaries may enroll in Blue Cross of Idaho Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at www.medicare.gov.

CONTACT US

Submit feedback about your health plan directly to Medicare, or find Medicare contacts, such as your State of Idaho Ombudsman.

PHONE

Call from 8 am to 8 pm
7 days a week

Toll-Free: 1-888-492-2583
TTY 1-800-377-1363

ADDRESS

3000 E Pine Ave.
Meridian, ID 83642-5996

P.O. Box 8406
Boise ID 83707-2406

If you have special needs, the information on this site may be available in other formats or languages. To find out more call 1-888-494-2583.

Blue Cross of Idaho is a health plan with a Medicare contract. Enrollment in Blue Cross of Idaho plans depends on contract renewal.

Y0010_MK 14070 Approved 12-26-2013
Last updated 12-27-2013