AR Blue Cross - Medi-Pak Rx Basic (PDP) Arkansas Medicare Part D Plan S5795-003

AR Blue Cross - Medi-Pak Rx Basic Arkansas Medicare Part D Plan S5795-003-ARAR Blue Cross - Medi-Pak Rx Basic for Arkansas is a prescription drug plan (Medicare Part D Plan) that's available to seniors in Arkansas on Medicare. The Centers for Medicare & Medicaid Services (CMS) evaluated this plan's previous year performance and rated it 3.5 out of 5 stars ("Average") for quality.

If you enroll in this plan you'll pay the $40.80 monthly premium, and there's a $200.00 annual deductible before cost sharing begins. For more information about the costs, refer to the premium page. You can check out the coverage information on the coverage page, or click on the copayments page to see your costs at the pharmacy.

If you have low income subsidy (LIS) benefits, this Medicare Part D plan is not available to you.

Premium Details

Like all Medicare Part D plans sold in Arkansas, AR Blue Cross - Medi-Pak Rx Basic is a cost sharing based prescription drug plan (PDP). If you enroll in the AR Blue Cross - Medi-Pak Rx Basic PDP, you share in the overall costs with the insurer by paying a monthly premium, an annual deductible (if applicable), and copayments at your pharmacy.

The monthly premium is $40.80 ($489.60 paid annually), and the annual deductible is $200.00. For 2015, the maximum Part D deductible is $320. 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.

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”).

There are two situations that can change how much an Arkansas Medicare Part D plan costs you. If your income is low and you are accepted into the Extra Help program administered by Social Security, your premium could be lower. It's also possible that your premium could be higher due to a late entry penalty. Be sure to speak with an authorized Arkansas Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

AR Blue Cross - Medi-Pak Rx Basic for Arkansas seniors features an initial coverage limit (ICL) of $2,960, and there is a $200.00 deductible. Be aware that the ICL is calculated using the full retail price of your medications, not the amount paid by the insurance carrier. When you pick up your prescriptions you will need to make a co-payment. The co-payments page will show you your share at the pharmacy with this plan.

This prescription drug plan has a $200.00 deductible that must be paid before the ICP cost-sharing phase begins. The highest deductible Medicare allows is $320. This figure goes down a few dollars each year.

AR Blue Cross - Medi-Pak Rx Basic Initial Coverage Limit

Confused about the initial coverage limit? Don't be, because it's straight forward. If you enroll in the AR Blue Cross - Medi-Pak Rx Basic PDP, you share the cost of your prescriptions with Arkansas Blue Cross And Blue Shield, the insurer. You each pay your share until the amount spent at the pharmacy reaches $2,960. That's the initial coverage limit in Arkansas for plan year 2015. After that you are not covered (coverage gap) until your actual out-of-pocket costs qualify you for catastrophic coverage. Keep reading, because you are entitled to automatic discounts.

Medicare Part D Coverage Gap (Donut Hole)

When you reach the coverage gap, commonly called the donut hole, you pay for your medications yourself. Most seniors never go into the coverage gap, but it is possible to hit it quickly if you have expensive long-term prescriptions.

If you reach the ICL (most seniors don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costs hit $4,550 (excluding your monthly premiums and the amount paid by the plan). This is called the coverage gap or donut hole. The good news is that you get a 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs while you're in the gap. You get to the other side of the donut hole when you've spent $4,550, at which point you automatically qualify to receive catastrophic coverage from Medicare.

Additional Gap Coverage with AR Blue Cross - Medi-Pak Rx Basic

Some plans offer additional gap coverage. Arkansas Blue Cross And Blue Shield does not offer additional coverage with the AR Blue Cross - Medi-Pak Rx Basic PDP in Arkansas. 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 and/or coinsurances that you must pay when you pickup your medications. Here's the schedule for this plan:

Tier  Co-Pay AmountMedications in Tier
1$4.00390 Preferred Generics
2$15.001322 Non-Preferred Generics
3$40.00314 Preferred Brand Drugs
430%547 Non-Preferred Brand Drugs
525%397 Specialty Drugs

The AR Blue Cross - Medi-Pak Rx Basic Medicare Part D plan uses Arkansas Blue Cross And Blue Shield formulary number 00015023, which covers 2970 generic and brand name drugs.

Compare Plans

Here are some Arkansas PDPs worth comparing with this plan:


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.

This catalog is maintained by David Bynon and was last updated on 9/13/2015. CMS File Date: October 15, 2014.

About Arkansas Blue Cross And Blue Shield

For more information, download the Summary of Benefits Not Available, visit the Arkansas Blue Cross And Blue Shield website, or call Arkansas Blue Cross And Blue Shield at N/A.