Information for Medicare Members. Mail Order. Pharmacy Program. Provided by. Prim Pharmacy
|
|
|
- Sharlene Collins
- 6 years ago
- Views:
Transcription
1 Information for Medicare Members Mail Order Pharmacy Program Provided by Prim Pharmacy
2 Prescription Refill Options You may order your prescription refills using the Internet, phone or U.S. Mail. To avoid running out of medication, order your refills on the date indicated on your prescription label. Prim Pharmacy provides the following convenient refill methods: Refill by Internet Log onto click on MyBlueService, then select Pharmacy Claims and Benefit Information You will need to have your prescription number and credit card information ready to enter Refill by Phone Dial Prim s refill line at: , TTY 711 Mon. - Fri, 8:00 a.m. - 12:00 a.m. EST, Sat. & Sun. 8:30 a.m. - 9:00 p.m. EST have your prescription number and credit card number information available; follow the system prompts to complete your refill order Refill by Mail Fill out the Prim Pharmacy Order Form that was included with your previous Prim prescription delivery Include appropriate payment
3 Time and Money Saving Tips If medically appropriate, ask for generics they usually cost less and generally meet the same FDA requirements for safety, purity, strength and quality as brand-name drugs Ensure the following necessary information is legible on your new prescription: The patient s full first name and last name The medication, strength, and directions for use The maximum quantity allowed by your plan limits Ensure your Prim Pharmacy Order Form is complete an incomplete form may cause a delay in processing your prescription
4 Overview As a Blue Cross and Blue Shield of Florida, Inc. member, you can participate in the Mail Order Pharmacy Program provided by Prim Pharmacy. Prim Pharmacy offers the convenience of home delivery with the safety and quality service you expect for your prescription drug needs. Convenience Medications are delivered to your home or work with refill amounts and dates noted on the prescription label. Quality Each prescription is verified for accuracy and dispensed by pharmacists who oversee every aspect of the process. Privacy Orders are handled discreetly and delivered in plain-labeled packaging with no indication of the contents. Safety A tamper-evident closure and secure packaging protect your order from breakage. How to Start Using Prim 1. For each long-term medication prescribed for you, ask your physician to write a prescription for the maximum-days supply your plan allows to be filled at Prim Pharmacy. 2. complete (in black ink) the Prim Pharmacy Order Form.
5 3. Mail to Prim Pharmacy in the enclosed envelope: Your completed Prim Pharmacy Order Form (no P.O. Boxes are accepted) Your original physician-signed maximum-day supply prescription* The appropriate payment* * You may submit more than one long-term prescription and payment in one order. Commonly Asked Questions Q: Why should I use Prim to fill my prescriptions? A: Prim offers you convenient prescription delivery to your home or work with refill amounts and dates noted on your prescription label. Q: How long does it take for my Prim prescription order to arrive? A: Prescriptions ordered through the mail usually arrive in 10 to 14 days, via U.S. Mail. Prescription refills ordered through the Internet or by phone offer faster turnaround. Your Prim prescription label indicates the date you should order your refill approximately three weeks before the end of your current supply.
6 Q: What if I want to order from Prim , but I need to begin taking my medication right away? A: ask your prescriber for two prescriptions one for a 14-day supply to fill immediately at a local retail pharmacy, and one for the maximum-days supply available under your plan to send to Prim Pharmacy. Q: Can I call in directly to Prim for refills? A: Yes. You may call , TTY 711, Mon. - Fri. 8:00 a.m. - 12:00 a.m. EST, Sat. & Sun. 8:30 a.m. - 9:00 p.m. EST to order refills through Prim s refill system. You may also reorder by logging on to clicking on MyBlueService, then selecting Pharmacy Claims and Benefit Information. Q: How can I pay for my prescriptions? A: You may pay via personal check, money order or credit card (MasterCard, Visa, American Express or Discover ). Paying with a credit card is the most convenient method for members, as Prim can retain the information on file for future prescription orders. (If payment is not included, Prim is unable to fill your prescriptions.)
7 Q: My physician wrote one 30-day prescription with two refills. Can you combine this and send me a 90-day supply? A: No. Prim Pharmacy must follow your physician s directions exactly as they are written on the prescription. To receive 90 days of medication all at once, you will need a new prescription from your physician, rewritten for a 90-day supply with up to three refills. Q: Can I get controlled-substance medications from Prim Pharmacy? A: Yes. Controlled-substance medications, such as Ritalin, Xanax, Valium, or Vicodin are available through Prim . Your quantity and refill amounts may be limited for controlled-substance medications in accordance with applicable pharmacy regulations. Q: Should I request generic drugs for my prescription? A: Yes. Ask your physician if there are cost-effective generic alternatives to your brand-name medications to reduce cost without sacrificing the quality or effectiveness of the drug. Q: Will Prim pharmacists automatically substitute a generic medication? A: Prim Pharmacy will dispense generic equivalents when available and appropriate and in accordance with applicable law.
8 Questions? Call Prim Pharmacy Member Service , TTY 711 Monday through Friday, 8:00 a.m. to 12:00 a.m. EST Saturday and Sunday, 8:30 a.m. to 9:00 p.m. EST Si usted desea obtener este folleto en español, por favor llame al número de atención al cliente indicado en su tarjeta de asegurado, y solicite ser transferido a un representante bilingue F L M P r i m e T h e r a p e u t i c s L L C 1 0 / 0 6
FAQs CVS Caremark Pharmacy Transition Effective January 1, 2012
FAQs Pharmacy Transition PERS Select/ Choice/ Care ID Cards Q. Will I receive a new prescription drug ID card? A. Yes. You should receive the new card from Anthem Blue Cross in mid-december for your prescription
Circular Letter September 26, 2011
c California Public Employees Retirement System Health Plan Administration Division P.O. Box 1953 Sacramento, CA 95812-1953 TTY: (877) 249-7442 (916) 795-0041; FAX (916) 795-1513 www.calpers.ca.gov Reference
Moving from Pediatric to Adult Care: Prescription Medicines, Supplies, and Equipment
Moving from Pediatric to Adult Care: Prescription Medicines, Supplies, and Equipment To take care of your own health, you need to know how to fill prescriptions. Most prescriptions for medicines can be
Using your pharmacy benefit
Using your pharmacy benefit Your pharmacy benefit services OptumRx is your plan s pharmacy services manager and is committed to helping you find cost-effective ways to get your medication(s). Set up your
Prescription Medication Schedule of Benefits
Prescription Medication Schedule of Benefits Rx Member Cost-Sharing: $15/$35/$70/$70 When you go to a pharmacy that participates in the UPMC Health Plan pharmacy network, you will be able to receive coverage
Prescription Drug Schedule of Benefits
Prescription Drug Schedule of Benefits Rx Member Cost-Sharing: $5/$15/$35/$35 When you go to a pharmacy that participates in the UPMC Health Plan pharmacy network, you will be able to receive coverage
Prescription Drug Rider
Prescription Drug Rider Rx Member Cost-Sharing: $10/$25/$40/$40 According to this prescription drug program, you may receive coverage for prescription drugs in the amounts specified in your rider when
Customized Delivery Solutions Mail Order
Mail Order Welcome to Apogee Bio Pharm s Mail Order Service! Our program is designed for members who are taking medications on an ongoing basis, such as medication to reduce blood pressure or to treat
Blue Cross MedicareRx (PDP) SM
(PDP) SM Summary of Benefits January 1, 2014 December 31, 2014 Y0096_BEN_IL_PDPSB14 Accepted 10012013 31980.0613 SECTION I Introduction to the Summary of Benefits for SM January 1, 2014 December 31, 2014
BlueScript for Medicare Part D Option 1
Prescription Drug Plan for Medicare Beneficiaries BlueScript for Medicare Part D Option 1 S5904 2006 Summary of Benefits January 1, 2006 - December 31, 2006 State of Florida Section 1 - Introduction to
You have three health plan options for 2006 Blue Cross HMO (CaliforniaCare), Kaiser Permanente HMO and Blue Cross PPO.
Flex FAQs Health Plans and Prescription Drug Coverage 1. Have the health plan choices changed? You have three health plan options for 2006 Blue Cross HMO (CaliforniaCare), Kaiser Permanente HMO and Blue
Understanding your Pharmacy Benefit
Understanding your Pharmacy Benefit At UnitedHealthcare, we want to help you get the most out of your pharmacy benefit. Here, you'll find answers to some frequently asked questions, because we re dedicated
Blue Shield Medicare Basic Plan (PDP) Blue Shield Medicare Enhanced Plan (PDP)
Summary of Benefits January 1, 2014 December 31, 2014 State of California S2468_13_228 CMS Accepted 09102013 SECTION I INTRODUCTION TO SUMMARY OF BENEFITS Thank you for your interest in and. Our plans
Questions and Answers. When should I use mail order pharmacy services? What is my co payment for drugs? What is my co payment for preferr
WPDP/Moda Health Pharmacy Program Welcome to your new pharmacy program, offered through the Washington Prescription Drug Program (WPDP) and administered by Moda Health, formerly ODS Health. At Moda Health,
Frequently Asked Questions
Frequently Asked Questions What is PrimeMail? PrimeMail is a full service home delivery pharmacy. Services include: Filling a new prescription(s) Refilling your existing prescription(s) Transferring your
Mail your completed claim form(s) and original, Medicare Part D Drug Claim Form detailed pharmacy receipts to:
Prime Therapeutics Questions about completing this form? Call 401-227-2958 or 1-800-267-0439 TTY: 711 8 a.m. 8 p.m.* Mail your completed claim form(s) and original, Medicare Part D Drug Claim Form detailed
Individual Enrollment Form
Individual Enrollment Form 2019 Focus DC (HMO SNP) A Medicare Advantage Special Needs Plan Focused on Diabetes Care How to Fill Out This Form IMPORTANT Please read! This form has eight pages numbered Page
Get the most from your prescription benefit
Get the most from your prescription benefit TE Connectivity HealthFund HRA Plan Welcome to Express Scripts What s Inside Your benefit at a glance...2 Your plan s preferred medicines...2 Prior authorization...2
Prescription Medication Rider
Prescription Medication Rider Rx Member Cost-Sharing: $16/$40/$80/$90 According to this prescription medication program, you may receive coverage for prescription medications in the amounts specified in
Annual Notice of Change for 2019
TEAMStar Medicare Part D (PDP) TEAMStar Bronze Plan offered by The International Brotherhood of Teamsters Voluntary Employee Benefits Trust Annual Notice of Change for 2019 You are currently enrolled as
YOUR TRUST PLAN BENEFITS
YOUR TRUST PLAN BENEFITS Benefit Overview Express Scripts Medicare (PDP) for the Insurance Trust for Delta Retirees (ITDR) YOUR 2017 PRESCRIPTION DRUG PLAN BENEFIT Here is a summary of what you will pay
2019 Summary of Benefits Booklet
P.O. Box 30006, Pittsburgh, PA 15222-0330 2019 Summary of Benefits Booklet For Pfizer U.S. retirees Employer PDP sponsored by Pfizer A Medicare Prescription Drug Plan (PDP) offered by Insurance Company
Summary of Benefits for Blue Shield Medicare Basic Plan (PDP) Blue Shield Medicare Enhanced Plan (PDP) Blue Shield Medicare Premium Plan (PDP)
Summary of s for Blue Shield Blue Shield Blue Shield January 1, 2012 December 31, 2012 State of California S2468 S2468_11_134 CMS Approved 09012011 blueshieldca.com Section I Introduction to Summary of
Your prescription drug plan
Your prescription drug plan Your Prescription Drug 15-30-60 or 20% with $150 Deductible Plan Up to a 30-day medication supply at participating retail pharmacies Up to a 90-day medication supply delivered
Your Medicare Prescription Drug Coverage as a Member of UA Medicare Group Part D EVIDENCE OF COVERAGE (EOC)
January 1 December 31 2010 Your Medicare Prescription Drug Coverage as a Member of UA Medicare Group Part D EVIDENCE OF COVERAGE (EOC) This booklet gives you the details about your Medicare prescription
Your Prescription Drug Benefit Handbook
Your Prescription Drug Benefit Handbook Welcome! We're proud that your health plan has chosen Medco to manage your prescription drug benefit for retail and mail-order services. You're now with the industry
Your Prescription Drug Plan Renewal Materials
Your Prescription Drug Plan Renewal Materials Here are your Express Scripts Medicare (PDP) renewal materials for the 2019 plan year. Please remember that your renewal in this plan is automatic no action
Prescription Medication Rider
Prescription Medication Rider Rx Member Cost-Sharing: $16/$40/$80/$90 HealthyU HIA/HRA According to this prescription medication program, you may receive coverage for prescription medications in the amounts
Get the most from your prescription-drug benefit
Get the most from your prescription-drug benefit 2018 Welcome to Express Scripts At Express Scripts, the company chosen by Ohio State Highway Patrol Retirement System to manage your prescription-drug benefit,
Annual Notice of Changes for 2019
SilverScript Choice (PDP) offered by SilverScript Insurance Company Annual Notice of Changes for 2019 You are currently enrolled as a member of SilverScript Choice (PDP). Next year, there will be some
Your medicine, your way. Start using home delivery today.
Your medicine, your way. Start using home delivery today. Health benefits and health insurance plans contain exclusions and limitations. Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a
Manage your Prescriptions Online Through the Express Scripts Pharmacy
Manage your Prescriptions Online Through the Express Scripts Pharmacy www.express-scripts.com Customer service specialists are also available 24 hours a day/7 days a week at 1-800-711-0917. Get a 90-day
welcome blueshieldca.com/med_formulary University of California Medicare PPO with Prescription Drug
welcome Welcome to the Blue Shield of California Medicare Rx Plan (PDP) an employer group/union-sponsored Medicare Part D plan for eligible retirees. This plan provides you access to enhanced Medicare
Stevens Institute of technology
Get the most from your prescription benefit Stevens Institute of technology At Express Scripts, the company chosen by Stevens Institute of Technology to manage your prescription benefit, your health is
Visit us at Groups.RxMedicarePlans.com. If you have special needs, this document may be available in other formats.
Visit us at Groups.RxMedicarePlans.com. Prospective members, please contact your benefits administrator. For more information about Medicare, please call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY
Your Prescription Drug
Your Prescription Drug BENEFIT PROGRAM This prescription drug benefit program provides pharmacy coverage for you and your family. P r e s c ription Dru g Covered benefits Coverage* includes self-administered
Get the most from your
Get the most from your FOREIGN SERVICE BENEFIT PLAN (FSBP) Welcome to Express Scripts What s Inside Your benefit at a glance...2 FSBP s preferred medicines...2 Coverage limits...3 Home delivery overseas...5
YOUR TRUST PLAN BENEFITS
YOUR TRUST PLAN BENEFITS Benefit Overview Express Scripts Medicare (PDP) for the Insurance Trust for Delta Retirees (ITDR) YOUR 2018 PRESCRIPTION DRUG PLAN BENEFIT Here is a summary of what you will pay
TRS-Care 2 and 3 Medicare Part D plans Express Scripts Medicare prescription plan FAQs
TRS-Care 2 and 3 Medicare Part D plans Express Scripts Medicare prescription plan FAQs General Questions What is Medicare Part D? Express Scripts Medicare for TRS-Care is a Medicare Part D plan. Medicare
Excellus BlueCross BlueShield Participating Provider Manual. 5.0 Pharmacy Management
Excellus BlueCross BlueShield Participating Provider Manual 5.0 Pharmacy Management 5.1 Pharmacy Benefits The Health Plan is committed to effectively managing prescription drug benefit costs and providing
2014 Summary of Benefits. Empire Plan Medicare Rx sponsored by New York State Health Insurance Program (NYSHIP)
SilverScript Insurance Company Empire Plan Medicare Rx P.O. Box 52424, Phoenix, AZ 85072-2424 Empire Plan Medicare Rx sponsored by New York State Health Insurance Program (NYSHIP) 2014 Summary of Benefits
2019 Enrollment Request Form
2019 Enrollment Request Form Please contact SOLIS Health Plans, Inc. (HMO) if you need information in another language or format (Braille). To Enroll in SOLIS Health Plans, Please Provide the Following
Arkansas State University System Prescription Drug Program
Arkansas State University System Prescription Drug Program The Arkansas State University (ASU) prescription drug program involves a partnership with the University of Arkansas for Medical Sciences (UAMS)
Contents General Information General Information
Contents General Information... 1 Preferred Drug List... 2 Pharmacies... 3 Prescriptions... 4 Generic and Preferred Drugs... 5 Express Scripts Website and Mobile App... 5 Specialty Medicines... 5 Prior
ConnPACE. Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled. Program Information and Application
ConnPACE Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled Program Information and Application Annual Open Enrollment Period November 15 to December 31 For Assistance, Please
UNDERSTANDING & MAKING THE MOST OF YOUR PHARMACY BENEFITS
UNDERSTANDING & MAKING THE MOST OF YOUR PHARMACY BENEFITS Prescription drug benefits are an important part of your medical plan benefit. Here s how you can find important information to help you understand,
Asuris Northwest Health Medicare Prescription Drug Plans (PDP)
2016 Asuris Northwest Health Medicare Prescription Drug Plans (PDP) Decision Guide for Oregon and Washington Y0062_PDPDCGD16v2 Accepted STEP-BY-STEP STEP 1 STEP 2 STEP 3 STEP 4 READ. This booklet provides
2018 FAQs. Prescription drug program. Frequently Asked Questions from employees
2018 FAQs Prescription drug program Frequently Asked Questions from employees September 2017 Prescription drug program Questions we ve heard our employees ask Here are some commonly asked questions about
Effective January 1 December 31, Summary of Benefits. Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP) blueshieldca.com/findamedicareplan
Effective January 1 December 31, 2018 Summary of Benefits Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP) blueshieldca.com/findamedicareplan S2468_17_217A_003_004 Accepted 08252017 We all have
FREQUENTLY ASKED QUESTIONS ABOUT THE CVS CAREMARK PRESCRIPTION DRUG PROGRAM
FREQUENTLY ASKED QUESTIONS ABOUT THE CVS CAREMARK PRESCRIPTION DRUG PROGRAM ABBVIE EMPLOYEES WANT TO KNOW 2018 Pharmacy Benefit Changes Q. What is the new prior authorization program? A. Certain brand
The Secure Horizons. For Secure Horizons Medicare+Choice Plan Members. Member Handbook
The Secure Horizons Discount Drug Program For Secure Horizons Medicare+Choice Plan Members Member Handbook Secure Horizons Discount Drug Program is an exclusive provider of the Medicareapproved drug discount
Prescription Assistance Program
Prescription Assistance Program Membership Enrollment Form Member Information First Name: MI: Last Name: DOB (mm/dd/yy): / / Social Security Number: - - Street Address: City: St: Zip: Telephone: Membership
(PDP) 2014 Summary of benefits for our Medicare prescription drug plans (Enhanced and Standard)
(PDP) 2014 Summary of benefits for our prescription drug plans (Enhanced and Standard) Contract S5540, Plans 004 and 002 January 1, 2014 December 31, 2014 U5073c, 8/13 Y0079_6249 CMS Accepted 09112013
SYMPHONIX RITE AID VALUE RX (PDP)
SYMPHONIX RITE AID VALUE RX (PDP) and SYMPHONIX RITE AID PREMIER RX (PDP) (a Medicare Prescription Drug plan (PDP) offered by SYMPHONIX HEALTH INSURANCE, INC. with a Medicare contract) Summary of Benefits
Farm Bureau Essential Rx 2018 Summary of Benefits January 1, December 31, 2018
Farm Bureau Health Plans P.O. Box 266380 Weston, FL 33326 Farm Bureau Essential Rx 2018 Summary of Benefits January 1, 2018 - December 31, 2018 Thank you for your interest in Farm Bureau Essential Rx.
WORKSAFENB DIRECT-PAY PRESCRIPTION DRUG PROGRAM
WORKSAFENB DIRECT-PAY PRESCRIPTION DRUG PROGRAM WHAT IS THE WORKSAFENB DIRECT-PAY PRESCRIPTION DRUG PROGRAM? It is an online prescription drug program available in all pharmacies throughout New Brunswick
This Member Health Statement reflects medical and pharmacy claims finalized within the preceding 28 days. Member Health Statement THIS IS NOT A BILL
PO BOX 1798 532 RIVERSIDE AVENUE JACKSONVILLE, FL 32231-0014 GARY J. BLUE 2121 BLUECROSS WAY JACKSONVILLE, FL 32246-0023 HOW CAN BLUE HELP YOU? If you have any questions about your claims activity, please
HealthSpring Prescription Drug Plan (PDP) 2013 Summary of Benefits S5932
HealthSpring Prescription Drug Plan (PDP) 2013 Summary of Benefits S5932 Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii,
PHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 1/18/18 SECTION: DRUGS LAST REVIEW DATE: 8/13/18 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
STEP THERAPY Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy Coverage Guideline must
2018 Summary of Benefits Booklet
P.O. Box 52424, Phoenix, AZ 85072-2424 2018 Summary of Benefits Booklet For Pfizer U.S. retirees Employer PDP sponsored by Pfizer A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with
Annual Notice of Changes for 2019
Senior Care Options Program (HMO SNP) offered by Commonwealth Care Alliance Annual Notice of Changes for 2019 You are currently enrolled as a member of Senior Care Options Program. Next year, there will
Individual Enrollment Form
Individual Enrollment Form 2019 Prime (HMO-POS), Select (LPPO), Flex (RPPO), Value Plus (HMO), and Value (HMO) Plans You can enroll using this form or: Enroll online at MartinsPoint.org/Medicare Enroll
QUICK TIP: Download a Quick Reference Guide from the Resource Center to help you use the PayFlex member website.
[Date] Dear DTE Energy Retiree, It s our pleasure to welcome you to PayFlex! You re enrolled in a Retiree Reimbursement Account (RRA). Your RRA comes with some great tools to help you manage your account.
FREQUENTLY ASKED QUESTIONS
FREQUENTLY ASKED QUESTIONS 4-11-13 1. What is the HDIEET-VEBA Partnership? High Desert and Inland Employee-Employer Trust (HDIEET) and California Schools VEBA (VEBA) are both joint labor-management trusts
You have from October 15 until December 7 to make changes to your Medicare coverage for next year.
Blue Cross MedicareRx Basic (PDP) SM offered by HCSC Insurance Services Company Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Cross MedicareRx Basic (PDP) SM. Next year,
Medicare Supplement Coverage Change Form
Medicare Supplement Coverage Change Form Please use this form for any of the following changes: o Change in Personal Information - Complete Sections 1 and 3 o Change Medicare Supplement Plan - Complete
7541 US HWY 87 E, Suite #1 San Antonio, Texas (210) PATIENT S EMPLOYER PLEASE CIRCLE ONE :
7541 US HWY 87 E, Suite #1 San Antonio, Texas 78263 (210) 648-9900 PATIENT S EMPLOYER PLEASE CIRCLE ONE : PPO POS HMO HRA HSA CHOICE PLUSE HEALTH SELECT OTHER NOTICE OF PRIVACY I have reviewed Beaver
Open Access Managed Plus plan
Open Access Managed Plus plan www.texashealthaetna.com 7T.02.100.1-TX (6/17) 1 Visit any doctor, no referrals needed A health insurance plan designed to meet your needs Get to know your new Texas Health
DTE Energy retirees: Welcome to PayFlex
DTE Energy retirees: Welcome to PayFlex You are enrolled in a Retiree Reimbursement Account (RRA). Your new RRA comes with some great tools to help you manage your account. Through the PayFlex member website,
Annual Notice of Changes for 2019
Annual Notice of Changes for 2019 Anthem MediBlue Plus (HMO) Offered by Anthem Blue Cross Next year, there will be some changes to the plan's costs and benefits. This booklet tells about the changes. 1-888-230-7338,
Summary of Benefits. Aetna Medicare Rx Costco Plus Plan (PDP) S5810. California. January 1, 2010 to December 31, 2010
January 1, 2010 to December 31, 2010 Summary of Benefits Aetna Medicare Rx S5810 California S5810_D_PE_SB_90712 (08/2009) Visit us www.aetnamedicare.com 1 Summary of Benefits: Aetna Medicare Rx Section
Choosing your Medicare Advantage plan is now easier than ever.
Choosing your Medicare Advantage plan is now easier than ever. We get it. Medicare, with all its Parts can get confusing. And, when it comes to choosing a Medicare Advantage plan that s right for you,
2019 Summary of Benefits Medicare Advantage Plans with Part D Prescription Drug Coverage. BlueMedicare Choice (Regional PPO) R
2019 Summary of Benefits Medicare Advantage Plans with Part D Prescription Drug Coverage R3332-001 January 1, 2019 December 31, 2019 The plan s service area includes: 1 Y0011_92076_M 0818 CMS Accepted
Medicare Part D Transition Policy CY 2018 HCSC Medicare Part D
Contract: H0107, H0927, H1666, H3251, H3822, H3979, H8133, H8634, H8554, S5715 Policy Name: Medicare Formulary Transition Purpose: This procedure describes the standard process Health Care Service Corporation
Medex 3 Plan 2013 Summary of Benefits with 3-Tier Prescription Drug Coverage: $5/$10/$25
Medex 3 Plan 2013 Summary of Benefits with 3-Tier Prescription Drug Coverage: $5/$10/$25 This Medex plan provides benefits for the: Medicare Part A Deductible and Co-insurances Medicare Part B Deductible
Annual Notice of Changes for 2019
EmblemHealth VIP Gold Plus (HMO) offered by HIP Health Plan of New York (HIP)/EmblemHealth Annual Notice of Changes for 2019 You are currently enrolled as a member of EmblemHealth VIP Gold Plus (HMO).
Annual Notice of Changes for 2018
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
Your Pharmacy Benefits Handbook
Your Pharmacy Benefits Handbook Summary of FCPS Prescription Benefits Available Through CVS Caremark Pharmacy Benefit Manager for Aetna/Innovation Health and CareFirst BlueChoice Advantage Plans Plan Year
SecurityBlue HMO. Link to Specific Guidance Regarding Exceptions and Appeals
SecurityBlue HMO Conditions and Limitations Potential for Contract Termination Disenrollment Rights and Instructions Exceptions, Prior Authorization, Appeals and Grievances Out-of-Network Coverage Quality
Annual Notice of Changes for 2018
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
2013 Summary of Benefits
2013 Summary of Benefits SilverScript Basic (PDP) SilverScript Choice (PDP) SilverScript Plus (PDP) January 1, 2013 December 31, 2013 S5601 SilverScript Basic (PDP), SilverScript Choice (PDP) and SilverScript
Office Policies. Clinic Timing: Monday to Friday: 8 am to 7 pm
Office Policies Thank you for choosing Progressive Medical Care (PMC) for your healthcare needs. Our mention is to provide you best available care in our resources and knowledge. Please take time to read/understand
Questions and answers about the Fixed Benefits Plan
Questions and answers about the Fixed Benefits Plan The Fixed Benefits Plan is a fixed indemnity plan. How does a fixed indemnity plan work? Fixed indemnity plans have no copays, deductibles, or coinsurance.
Please review the checklist on the next page to ensure that your application is complete and ready for submission.
Program Overview How to Complete this Application: 1. Review the information on this page carefully and keep it for your records. 2. Complete pages 3, 4 and 5 of the application. 3. Gather the required
EASY CHOICE MEDICARE ADVANTAGE PLANS
EASY CHOICE MEDICARE ADVANTAGE PLANS 2017 INDIVIDUAL ENROLLMENT FORM 1 2 3 4 5 How to Enroll with Easy Choice Please read this entire enrollment form to make sure you understand the information. When you
EVIDENCE OF COVERAGE A complete explanation of your plan
EVIDENCE OF COVERAGE A complete explanation of your plan Health Net Orange Option 1 (PDP) January 1, 2010 December 31, 2010 Important benefit information please read S5678_2010_0441 09/2009 January 1
WELLCARE/ OHANA MEDICARE ADVANTAGE PLANS INDIVIDUAL ENROLLMENT FORM
WELLCARE/ OHANA MEDICARE ADVANTAGE PLANS INDIVIDUAL ENROLLMENT FORM How to Enroll with WellCare/ Ohana 1 Please read this entire enrollment form to make sure you understand the information. 2 When you
BlueRx PDP. Link to Specific Guidance Regarding Exceptions and Appeals
BlueRx PDP Conditions and Limitations Potential for Contract Termination Disenrollment Rights and Instructions Exceptions, Prior Authorization, Appeals and Grievances Out-of-Network Coverage Quality Assurance
(PDP) Prescription drug coverage for Medicare beneficiaries Blue Medicare Rx (PDP) Y0079_XXX CMS Approved MMDDYYYY
2014 Blue Medicare Rx (PDP) Prescription drug coverage for Medicare beneficiaries (PDP) Y0079_XXX CMS Approved MMDDYYYY Y0079_6354 CMS Accepted 08272013 U5073a, 8/13 Contents Your guide to Blue Medicare
Annual Notice of Change
2019 Annual Notice of Change Essence Advantage Plus (HMO) Serving the Missouri counties of Jefferson, St. Charles, St. Louis and St. Louis City and the Illinois counties of Madison, Monroe and St. Clair
Your Prescription Drug Plan Materials
Your Prescription Drug Plan Materials We are pleased to provide you with your Express Scripts Medicare (PDP) plan materials for the 2018 plan year. These materials are for coverage through the Medicare
Annual Notice of Changes for 2018
EmblemHealth HMO Medicare Supplement (Cost) offered by HIP Health Plan of New York (HIP)/EmblemHealth Annual Notice of Changes for 2018 You are currently enrolled as a member of EmblemHealth HMO Medicare
Annual Notice of Changes for 2018
Simply Complete (HMO SNP) Offered by Simply Healthcare Plans Annual Notice of Changes for 2018 Next year, there will be some changes to the plan s costs and benefits. This booklet tells about the changes.
The State of New Mexico Group Benefits Plan Plan Year: January December 2018 Prescription Drug Program
The State of New Mexico Group Benefits Plan Plan Year: January December 2018 Prescription Drug Program 1 Who Is Express Scripts? Express Scripts administers your prescription drug benefit and you automatically
Summary of Benefits. Regence Medicare Script TM. Enhanced (PDP) Basic (PDP) Medicare Prescription Drug Plan for Utah
2013 Summary of Benefits Medicare Prescription Drug Plan for Utah Regence Medicare Script TM Enhanced (PDP) Regence Medicare Script TM Basic (PDP) Regence BlueCross BlueShield of Utah is an Independent
CanaRx Services Inc.
P.O. Box 44650 Detroit, MI 48244 0650 Toll Free Phone: 1-888-739-2718 Toll Free Fax: 1-866-715-6337 CanaRx Services Inc. GENERAL OVERVIEW Introduction: The substantial savings opportunities that CanaRx
2019 Pre-Medicare Retiree Healthcare Open Enrollment
2019 Pre-Medicare Retiree Healthcare Open Enrollment CHANGES ONLY ENROLLMENT Submit Enrollment Changes Before November 21 You MUST complete and submit the enclosed enrollment form by November 21 if you
SPD Prescription Drugs Plan
Prescription Drugs Plan 08/01/2017 3-1 Your Prescription Drug Benefits The prescription drug benefit available to you is based on the medical plan in which you are enrolled. Regardless of the benefit design
2019 ANNUAL NOTICE OF CHANGES
2019 ANNUAL NOTICE OF CHANGES Important changes to your plan UnitedHealthcare Senior Care Options (HMO SNP) Toll-free 1-888-867-5511, TTY 711 8 a.m. 8 p.m. local time, 7 days a week www.uhccommunityplan.com
Annual Notice of Changes for 2019
Eon Deluxe (HMO SNP) offered by Eon Health, Inc. Annual Notice of Changes for 2019 You are currently enrolled as a member of Eon Deluxe. Next year, there will be some changes to the plan s costs and benefits.