The Evidence of Coverage gives details about the coverage provided by Medi-Pak Rx^® plans, including what you will have to pay for your prescriptions, what is covered and what is not, and how to get your prescriptions filled.

Select the plan, offered by Arkansas Blue Cross and Blue Shield, you would like to view:

• Medi-Pak Rx Basic (PDF)
  

• Medi-Pak Rx Classic (PDF)
  

• Medi-Pak Rx Premier (PDF)
  

S5795_Rx_REV Website Submission (12/07/09)