BlueRx (PDP) is a Medicare drug plan and has a contract with the Federal government. I understand that this prescription drug coverage is in addition to my coverage under Medicare; therefore, I will need to keep my Medicare Part A or B coverage. It is my responsibility to inform BlueRx of any prescription drug coverage that I have or may get in the future. I can only be in one Medicare Prescription Drug Plan at a time - if I am currently in a Medicare Prescription Drug Plan, my enrollment in BlueRx will end that enrollment. Enrollment in this plan is generally for the entire year. Once I enroll, I may leave this plan or make changes if an enrollment period is available, generally during the Annual Enrollment Period (Example: October 15 - December 7 of every year) unless I qualify for special circumstances.

BlueRx serves a specific service area. If I move out of the area that BlueRx serves, I need to notify the plan so I can disenroll and find a new plan in my area. I understand that I must use network pharmacies except in an emergency when I cannot reasonably use BlueRx network pharmacies. Once I am a member of BlueRx, I have the right to appeal plan decisions about payment or services if I disagree. I will read the Evidence of Coverage document from BlueRx when I get it to know which rules I must follow to get coverage.

I understand that if I leave this plan and don't have or get other Medicare Prescription Drug Coverage or creditable prescription drug coverage (as good as Medicare's), I may have to pay a late enrollment penalty in addition to my premium for Medicare prescription drug coverage in the future.

I understand that if I am getting assistance from a sales agent, broker, or other individual employed by or contracted with BlueRx, he/she may be paid based on my enrollment in BlueRx. Counseling services may be available in my state to provide advice concerning Medicare supplement insurance or other Medicare Advantage or Prescription Drug plan options, medical assistance through the state Medicaid program, and the Medicare Savings Program.

BlueRx (PDP) is a Medicare-approved Part D plan. Enrollment in BlueRx (PDP) depends on contract renewal.

BlueRx (PDP) is provided by Blue Cross and Blue Shield of Alabama and UTIC Insurance Company, independent licensees of the Blue Cross and Blue Shield Association.