AR Blue Cross - Medi-Pak Rx Basic for Arkansas is Medicare Prescription Drug Plan (Part D Plan or PDP) for seniors and other Medicare beneficiaries in Arkansas. According to the Centers for Medicare and Medicaid Services (CMS), this plan's quality is Average, and rated it 3.5 out of 5.0 stars.
If you choose to enroll you will pay $40.10 per month (the premium). In addition to the premium there is a $300.00 annual deductible. You can find out more about the costs associated with this plan in the premium section of this page. You can check out the coverage information in the coverage secrion, or look at the copayments section to see your costs at the pharmacy.
AR Blue Cross - Medi-Pak Rx Basic does not pay all costs; it's a cost sharing plan. If you join, you share in the overall costs with Arkansas Blue Cross And Blue Shield by paying a monthly premium, an annual deductible (if applicable), and copayments and/or coinsurance at your pharmacy.
This plan's annual premium is $481.20 ($40.10 paid monthly). It's priced as follows:
This plan is not available to people receiving low income subsidy (LIS) benefits.
This plan has a $300.00 deductible (annual). For 2016, the maximum Part D deductible is $360. A plan with the maximum deductible does not necessarily mean that it is more expensive than a plan with a lower deductible or no deductible at all. You need to consider all costs.
You Pay the Premium + Deductible + Copayments
Be aware that you must continue to pay your monthly premium even when you are not using any medications. Also, it's important to plan ahead because you are responsible for one hundred percent of your prescription costs until the plan's deductible has been met. You also make the required copayment when you pickup your prescriptions. These are your share of the prescription drug costs. The plan pays the rest until you reach the coverage gap (aka, “donut hole”).
What You Pay Could Be Different
Most people pay the standard premium. However, if you qualify for Extra Help with your Medicare Part D plan due to your income, your premium may be lower or cost you nothing at all. But, if you did not enroll in a Part D plan as soon as you were first eligible, Medicare can impose a penalty and your premium will be higher. To get an exact rate for your situation, contact a Arkansas Medicare Insurance Agent.
AR Blue Cross - Medi-Pak Rx Basic is a Basic Alternative PDP. At a minimum, Arkansas Blue Cross And Blue Shield must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:
- are actuarially equivalent to the standard benefit; or
- are enhanced, offering benefits in addition to the standard benefit.
Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.
Initial Coverage Limit
It's important to understand the initial coverage limit (ICL) and how it applies to you in Arkansas. The ICL is where you share the cost of your prescriptions with the insurance company. You and Arkansas Blue Cross And Blue Shield each pay your share until you reach a total of $3310.00 spent at the pharmacy on prescriptions. At that point you pay all costs yourself because you're in the coverage gap, as explained below.
Coverage Gap (aka, Donut Hole)
The coverage gap, or donut hole, as it is often called, is the coverage phase where you no longer receive assistance from the plan. In other words, you pay for your prescriptions out-of-pocket. How quickly you reach the coverage gap with AR Blue Cross - Medi-Pak Rx Basic all depends on your prescriptions. Most seniors never fall into the donut hole.
When you're in the donut hole you pay all of the costs for your medications, but at a discounted rate (47.5% off of brand-name drugs and 28% off generics). You continue to pay this until your out-of-pocket costs reach $4,550. At this point Medicare takes over by giving you catastrophic coverage. The $4,550 out-of-pocket figure does not include your monthly premiums or what Arkansas Blue Cross And Blue Shield pays.
Additional Gap Coverage
AR Blue Cross - Medi-Pak Rx Basic does not offer additional assistance in the coverage gap. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Arkansas Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.
Copayment & Coinsurance Details
In addition to the monthly premium and annual deductible, the AR Blue Cross - Medi-Pak Rx Basic prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:
|Tier||You Pay||Medications in Tier|
|3||$42.00||Preferred Brand Drugs|
|4||$95.00||Non-Preferred Brand Drugs|
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you lookup your prescriptions in the plan's formulary.
AR Blue Cross - Medi-Pak Rx Basic has an overall rating of 3.5 out of 5 stars. This summary rating was assigned by the Centers for Medicare and Medicaid Services (CMS) based on the plan's previous year performance. It provides shoppers with an overall score on the drug plan's quality and performance across 3 broad categories:
- Drug plan customer service (2.0 stars): Includes handling of member appeals.
- Member experience with the plan's drug services (5.0 stars): Includes ratings of member satisfaction with the plan.
- Drug safety and accuracy of drug pricing (4.0 stars): Includes how accurate the plan's pricing information is and how often members with certain medical conditions are prescribed drugs in a way that is considered safer and clinically recommended for their condition.
CMS gathers quality information from several sources, including member surveys, reviews of billing and other information that plans submit to Medicare, and other monitoring activities.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the AR Blue Cross - Medi-Pak Rx Basic prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Little Rock, Fort Smith, Fayetteville, Springdale, Jonesboro, Rogers, Pine Bluff, Conway, and all other towns and cities in Arkansas.
About Arkansas Blue Cross And Blue Shield
This PDP information is maintained by David Bynon and was last updated on .