IMRF Endorsed Plans

Prescription Drug Plans

Blue Cross and Blue Shield Medicare Part D

• Available to retirees residing in Illinois
• The stand alone plans listed below are independent of medical coverage plans

	Value Plan	Plus Plan	Standard Plan
Deductible	$0.00	$0.00	$275.00
Generic co-pay	7.00	5.00	0.00
Preferred brand co-pay	45.00	38.00	35.00
Brand name co-pay	75.00	60.00	65.00
Mail order/Preferred Pharmacy	2.5x the co-pay	2.5x the co-pay	25%
Monthly premium	$27.80	$70.10	$31.60

• Fees listed above apply until you reach $2,510.00 in annual drug costs. After annual drug costs exceed $2,510.00, the Value and Standard plans require you to pay 100% of drug costs until your out-of-pocket costs exceed $4,050.00. The Plus Plan requires a $5.00 co-pay for generics and 100% of any other drugs during this time. Once your out-of-pocket drug costs exceed $4,050.00 for all three plans you pay the greater of a $2.25 co-payment for generic ($5.60 for preferred brand or brand name) or 5% coinsurance. You pay 5% for specialty drugs.
  

65 and Over Plans Blue Cross and Blue Shield of Illinois Plan F Loyal American Seniors Choice Humana Private Fee for Service Plan Health Alliance United Healthcare Missouri Mercy Health Plan Premier Plus Blue Cross and Blue Shield of Texas Plans Humana Regional PPO NEW PLAN! Prescription Drug Plans Blue Cross and Blue Shield Medicare Part D Humana Medicare Part D Plans Sav-Rx Plan Sav-Rx Enrollment Form Delta Dental About Delta Plan Delta Dental Enrollment Form Under 65 Plans Blue Cross and Blue Shield of Illinois - Under 65 Plan Request Personalized Quote Long Term Care About the Plan SPECTERA Vision Plan About the Plan