Medex 2 Benefits at a Glance
Benefit Plan Pays
Preventive care, routine physicals, GYN, routine hearing and vision exams $15 per visit
Office visits (sick care/ non-Preventive)
 Full coverage of Medicare deductible and coinsurance after a $15 copayment per visit
Emergency room Full coverage of Medicare deductible and coinsurance after a $50 copayment per visit (waived if admitted for observation stay)
Inpatient hospital care After a $50 calendar-quarter copayment:

Full coverage of Medicare deductible and coinsurance

Full coverage of lifetime reserve day coinsurance

Full coverage of up to 365 additional hospital days in your lifetime when Medicare benefits are used up
Outpatient surgery Full coverage of Medicare deductible and coinsurance
CT scans, MRIs, and other imaging tests Full coverage of Medicare deductible and coinsurance

 

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Prescription Drug Coverage

For prescription drug coverage, you also need to enroll in Blue MedicareRxSM. Covered medications are separated into three tiers, and the amount you pay depends on the medication's tier. You pay the following until your total yearly drug costs reach $1,500. For more information, download the Download Summary of Benefits.

Prescription Drug Benefits You Pay
Retail pharmacies (up to a 30-day supply) $10 for generic drugs
$25 for preferred drugs
$45 for non-preferred drugs
Mail service pharmacy (up to a 90-day supply) $20 for generic drugs
$50 for preferred drugs
$115 for non-preferred drugs
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