Arkansas BlueCross Blue Shield Medi-Pak Choice
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Our Medi-Pak Plans

Review our plans for:
ZIP code , County

  I want to:

Your plan benefits coverage for what Medicare does not pay

    With Plan A,
You Pay
With Plan F,
You Pay
With Plan G,
You Pay
 With Plan N,
 You Pay
  Monthly Premium $91.50 $128.90 $111.30 $92.00
 
  $1,156 inpatient hospital deductible each benefit period  Inpatient hospital deductible $0 $0 $0
  $289 copayment, per day, for days 61-90 in a hospital $0 $0 $0 $0
  $578 copayment, per day, for days 91-150 in a hospital $0 $0 $0 $0
  Additional 365 days after Medicare hospital benefits end $0 $0 $0 $0
  Calendar year blood deductible $0 $0 $0 $0
  Hospice care $0 $0 $0 $0
  $144.50 copayment, per day, days 21-100 in a skilled nursing facility Copayments $0 $0 $0
 
  $140 Part B deductible Part B
Deductible
$0 Part B
Deductible
Part B
Deductible
  Part B
coinsurance for:
     Health care provider visits $0 $0 $0 Lesser of a
$20 copayment
or the Part B coinsurance
     Emergency room visits $0 $0 $0 Lesser of a
$50 copayment
or the Part B coinsurance
     All other Part B services $0 $0 $0 $0
  Excess charges 100% $0 $0 100%
 
  Emergency care in a foreign country* 100%  $250 deductible
then 20%
coinsurance
 $250 deductible
then 20%
coinsurance
$250 deductible
then 20%
coinsurance
  SilverSneakers® $0 $0 $0 $0

More Information
When Should I Apply (Enrollment Guidelines)?
Disclaimers
SilverSneakers®
You Pay Nothing

*$50,000 lifetime maximum applies.

Prescription drug plans are not covered under Medi-Pak®. If you would like to learn more about our Medicare Part D prescription drug plan, view Medi-Pak Rx (PDP)® options.

Medicare enrollees with Medi-Pak® coverage may receive services from any provider that participates with Medicare.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact Arkansas Blue Cross and Blue Shield. This is an advertisement; for more information, contact a benefits specialist.