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Call Member Services at 1-800-926-6565 (TTY 1-800-955-8770)

Hours: 8:00 a.m. to 8:00 p.m. local time, seven days a week, from October 1 through March 31, except for Thanksgiving and Christmas. From April 1 through September 30, our hours are 8:00 a.m. to 8:00 p.m. local time, Monday through Friday, except for major holidays.

2025 BlueMedicare Premier Rx

•    S5904-001 - BlueMedicare Premier Rx (PDP) - Florida Statewide

•    2025 Evidence of Coverage - BlueMedicare Premier Rx - last updated 9/3/24

•    2025 Low Income Subsidy (LIS) - Extra Help Program - last updated 10/1/24

•    2025 Prescription Drug Transition Policy - last updated 8/14/24

2024 BlueMedicare Premier Rx

View and download important forms and documents about your BlueMedicare plan from Florida Blue.

  • S5904-001 - Florida Statewide

2024 Annual Notice of Changes Last Updated
2024 Annual Notice of Changes - Florida Statewide 9/18/2023

 

2024 Evidence of Coverage Last Updated
2024 Evidence of Coverage - Florida Statewide 7/26/2024

 

2024 Summary of Benefits Last Updated
2024 Summary of Benefits - Florida Statewide 9/18/2023

 

2024 Comprehensive Formulary Last Updated
2024 Comprehensive Formulary - Florida Statewide 10/23/2024

 

2024 Enrollment Form Last Updated
2024 Enrollment Form 9/8/2023

 

2024 Medicare Star Rating Last Updated
2024 Medicare Star Rating 10/22/2023

 

2024 Prescription Drug Transition Policy Last Updated
2024 Prescription Drug Transition Policy 09/20/2023

 

2024 Low-Income Subsidy - Extra Help Program Last Updated
2024 Low-Income Subsidy - Extra Help Program 09/11/2023

 

FBM FORM NF
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Last Updated: 10.01.2024
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