Anthem MediBlue Rx Standard (PDP)

Anthem MediBlue Rx Standard (PDP) S5596-085 Plan Details

3.5 out of 5 stars

Anthem MediBlue Rx Standard (PDP) is a plan offered by Anthem Inc..
Plan ID: S5596-085.

^$85.50

Monthly Premium

Anthem MediBlue Rx Standard (PDP) is a plan offered by Anthem Inc..
Plan ID: S5596-085.

Anthem MediBlue Rx Standard (PDP) S5596-085 Plan Details

3.5 out of 5 stars

Anthem MediBlue Rx Standard (PDP) is a plan offered by Anthem Inc..
Plan ID: S5596-085.

^$85.50

Monthly Premium

Georgia Counties Served

Appling Baker Baldwin Barrow Bartow Bryan Clarke Spalding Paulding Atkinson Bacon Banks Ben Hill Berrien Bibb Bleckley Brantley Brooks Bulloch Burke Butts Calhoun Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur Dekalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Floyd Forsyth Franklin Fulton Gadsden Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion Mcduffie Mcintosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Russell Schley Screven Seminole Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$505
Out of Pocket Max	In-Network: $-1 Out-of-Network: N/A
Initial Coverage Limit	$4660
Catastrophic Coverage Limit	$7,400

Prescription Drug Costs and Coverage

The Anthem MediBlue Rx Standard (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $505 (excludes Tiers 1 and 2) per year.

Coverage	Cost
Coverage & Cost
Annual Drug Deductible	$505 (excludes Tiers 1 and 2)
Preferred Generic	Preferred cost-share retail $1.00 Standard retail $2.00 Standard mail order $1.00
Generic	Preferred cost-share retail $3.00 Standard retail $4.00 Standard mail order $3.00
Annual Drug Deductible	$505 (excludes Tiers 1 and 2)
Preferred Generic	Preferred cost-share retail $2.00 Standard retail $4.00 Standard mail order $2.00
Generic	Preferred cost-share retail $6.00 Standard retail $8.00 Standard mail order $6.00
Annual Drug Deductible	$505 (excludes Tiers 1 and 2)
Preferred Generic	Preferred cost-share retail $3.00 Standard retail $6.00 Standard mail order $3.00
Generic	Preferred cost-share retail $9.00 Standard retail $12.00 Standard mail order $9.00

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Anthem MediBlue Rx Standard (PDP)

Georgia Counties Served

Basic Costs and Coverage

Prescription Drug Costs and Coverage

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