Prescription Benefit Summaries: Personal Choice — Groups 51+IBC Forms Online
The Prescription Benefit Summaries: Personal Choice section provides a comprehensive list of Independence Blue Cross prescription benefit summaries for you to access. Select the desired plan to view the available benefits summaries.
Forms are in pdf format.
| Option | Last Updated |
|---|---|
| $0/$25/$50 | 2010-03 |
| $10/$20/$35 | 2010-03 |
| $10/$20/$50 | 2010-03 |
| $10/$30/$50 | 2010-03 |
| $15/$35/$50 | 2010-03 |
| $20/$40/$60 | 2010-03 |
| $250/$20/$40/$60 | 2010-03 |
| $250/$5/$40/$60 | 2010-03 |
| $500/$15/$50/$75 | 2010-03 |
| $5/$10/$25 | 2010-03 |
| $5/$10/$35 | 2010-03 |
| $5/$10/50% | 2010-03 |
| $5/$10/50% | 2010-03 |
| $5/$15/$25 | 2010-03 |
| $5/$15/$35 | 2010-03 |
| $5/$15/$50 | 2010-03 |
| $5/$15/50% | 2010-03 |
| $5/$20/$35 | 2010-03 |
| $50/$20/$50 | 2010-03 |
| $5/$20/$50% | 2010-03 |
| $5/$30/$50 | 2010-03 |
| $5/$40/$60 | 2010-03 |
