go to content

Plan Options

MedicareBlue Rx

2008 Evidence of Coverage

Download the appropriate Evidence of Coverage for your product:

MedicareBlue Rx Option 1 (PDF)
MedicareBlue Rx Option 2 (PDF)
MedicareBlue Rx Option 3 (PDF)

May 17, 2008

Important Information

This page last updated and accepted by CMS January 2008.

MedicareBlue PPO and MedicareBlue Rx coverage is provided by only one of the following plans, depending on the state in which the policy is issued: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* and Blue Cross Blue Shield of Wyoming.*

*Independent licensees of the Blue Cross and Blue Shield Association.

R5566_122007_B07 RE

S5743_122007_B08 RE