S5715-014: Blue Cross MedicareRx Basic – 2025 Medicare Part D Plan Available in Texas
S5715-014: Blue Cross MedicareRx Basic – 2025 Medicare Part D Plan Available in Texas
CMS 5-Star Rating: (3.0 out of 5 stars*)
For 2025, the Blue Cross MedicareRx Basic Part D plan (S5715-014) is listed in the CMS Landscape dataset for Texas, including premium, deductible, and rating details.
* The Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
| Part D Plan Overview | |
|---|---|
| Part D Plan ID: | S5715-014 |
| Plan Year: | 2025 |
| Total Part D Premium: | $101.00 |
| Annual Deductible: | $590.00 |
| Part D Benefit Type: | Basic |
| No Deductible Drug Tier: | Not Applicable |
| Low Income Subsidy: | Yes |
| Insured By: | Blue Cross and Blue Shield of IL, NM, OK, TX |
Plan Costs
Premium Details
| Basic Part D Premium: | $101.00 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $101.00 |
| Low Income Premium Subsidy: | $18.30 |
| Low Income Premium Subsidy CMS Pays: | $18.30 |
| Low Income Subsidy Premium: | $82.70 |
TIP: Extra Help, formally known as the Low-Income Subsidy (LIS), provides financial support to lower prescription drug costs for qualified Medicare beneficiaries in Texas. Visit the Social Security Extra Help page for details.
Deductible
The deductible for the 2025 Blue Cross MedicareRx Basic PDP (S5715-014) is $590.00, based on the CMS Landscape dataset.
Out-of-Pocket Costs
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic | $1.00 | $10.00 | |
| Generic | $5.00 | $15.00 | |
| Preferred Brand | 18.00% | 18.00% | |
| Non-Preferred Drug | 49.00% | 50.00% | |
| Specialty Tier | 25.00% | 25.00% | |
| *Deductible does not apply. | |||
CMS 5-Star Rating Data for Plan S5715-014
The CMS 5-star system measures Medicare Part D plan quality, including service, member experience, and drug safety. A 5-star rating is the highest score.
| 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: .