BlueRxTn 2024

Step 1:
You Selected:
BlueRx Essential (PDP)
Copays as low as $1, Mail-Order Home Delivery Pharmacy Service available, 90-day supply for cost of 60-day supply
$72.00 per month
Step 2 of 10: Before you begin checklist page
Application for BlueRx (PDP)

Before You Begin: Be sure to have the following information available to assist in enrolling online.

  • Personal Information
  • Medicare Card
  • Medicaid Card (if applicable)
  • Pre-enrollment Packet (if applicable)
  • Long Term Care Institution Information (if applicable)
  • Other Insurance Coverage Information (if applicable)
  • Determine the desired benefit option for enrollment

If you are completing this enrollment on behalf of another individual:

  • You will need to be a court-appointed Legal Guardian or a person with Durable Power of Attorney for Health Care (DPAHC), who is authorized by State law.
  • After completing the online enrollment, you will need to mail a copy of proof of Legal Guardian, DPAHC, or proof of authorization by state law to Blue Cross and Blue Shield of Alabama.

If you currently have health coverage from an employer or union:

  • Joining BlueRx could affect your employer or union health benefits. You could lose your employer or union health coverage if you join BlueRx.
  • Please read the communications your employer or union sends you. If you have questions, visit their web site, or contact the office listed in their communications. If there is no information on whom to contact, your Benefits Administrator or the office that answers questions about your benefits coverage can help.

If you are a member of Medicare Advantage Plan (like an HMO or PPO):

  • You may already have a prescription drug benefit from your Medicare Advantage Plan that will meet your needs. By joining BlueRx, your membership in your Medicare Advantage plan may end. This will affect both your doctor and hospital coverage as well as your prescription drug benefits. Read the information that your Medicare Advantage plan sends you and if you have questions, contact your Medicare Advantage plan.

Up Next: Review Agreement

Medicare beneficiaries may also enroll in BlueRx through the CMS Medicare Online Enrollment Center located at .

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