S5715-021: Blue Cross MedicareRx Choice – 2025 Medicare Part D Plan
S5715-021: Blue Cross MedicareRx Choice – 2025 Medicare Part D Plan
CMS 5-Star Rating: (3.0 out of 5 stars*)
The Blue Cross MedicareRx Choice (PDP ID: S5715-021) is a Medicare Part D prescription drug plan available for 2025, listed in the official CMS Landscape dataset.
* The Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
| Part D Plan Overview | |
|---|---|
| Part D Plan ID: | S5715-021 |
| Plan Year: | 2025 |
| Total Part D Premium: | $60.60 |
| Annual Deductible: | $590.00 |
| Part D Benefit Type: | Enhanced |
| No Deductible Drug Tier: | Yes |
| Low Income Subsidy: | Yes |
| Insured By: | Blue Cross and Blue Shield of IL, NM, OK, TX |
Plan Costs
Premium Details
| Basic Part D Premium: | $45.10 |
| Supplemental Part D Premium: | $15.50 |
| Total Part D Premium: | $60.60 |
| Low Income Premium Subsidy: | $18.30 |
| Low Income Premium Subsidy CMS Pays: | $18.30 |
| Low Income Subsidy Premium: | $42.30 |
Did you know? The Extra Help program (LIS) can reduce premiums, deductibles, and copays for eligible Medicare Part D enrollees in Texas. Check eligibility at the Social Security Extra Help page.
Deductible
CMS data lists the deductible for the 2025 Blue Cross MedicareRx Choice PDP (S5715-021) as $590.00.
Out-of-Pocket Costs
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic* | $0.00 | $15.00 | |
| Generic* | $6.00 | $20.00 | |
| Preferred Brand | 17.00% | 17.00% | |
| Non-Preferred Drug | 39.00% | 40.00% | |
| Specialty Tier | 25.00% | 25.00% | |
| *Deductible does not apply. | |||
CMS 5-Star Rating Data for Plan S5715-021
CMS assigns Medicare Part D plans a 1–5 star rating each year, based on service, satisfaction, and drug safety. Higher stars reflect stronger performance.
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Blue Cross and Blue Shield of IL, NM, OK, TX
| Website: | Blue Cross and Blue Shield of IL, NM, OK, TX Plan Page |
|---|---|
| Formulary: | Blue Cross and Blue Shield of IL, NM, OK, TX Formulary Page |
| Pharmacy: | Blue Cross and Blue Shield of IL, NM, OK, TX Pharmacy Page |
| Prospective Part D Members: | (877)213-1817 |
| Prospective Part D TTY Users: | 711 |
Last update: .