PACE
Provider Bulletin
PACENET Premium for Additional IBC Plans
to be
Collected at Point of Sale
Effective for claims with a date of service of
|
IBC Plan Name |
Monthly Premium |
|
|
|
|
IBC
Personal Choice 65 Standard Rx |
$20.80 collected at pharmacy +
copay |
|
Keystone 65 Standard Rx, |
$35.40 * ($8.81 above benchmark) $26.59 collected at pharmacy +
copay |
|
Keystone 65 Value Rx, |
$20.80 collected at pharmacy +
copay |
|
Keystone 65 Value Plus Rx |
$29.60 * ($3.01 above benchmark) $26.59 collected at pharmacy +
copay |
*Cardholders whose monthly premium exceeds the $26.59
benchmark will continue to receive a separate monthly bill from the plan for
the monthly amount above the benchmark.
IMPORTANT: These PACENET cardholders enrolled themselves
in one of these four (4) plans and have NOT
been billed by IBC for the plan’s entire premium for the past 4 months.
Therefore, although this premium collection at the point of sale may be
unexpected, the cardholder should not be surprised that they are responsible
for paying a premium.
However, to avoid undue hardship for PACENET
cardholders, the Department has decided NOT to recover premium payments for medications
received by these cardholders from January through April.
NOTE: The
process for these four (4) plans will work the same as is currently in place
for IBC’s RX Option 1, the other Partner Plans and Geisinger’s Medicare
Advantage with Part D plans. That is, claims submitted for PACENET cardholders
will have the monthly premium included in the response back to the provider.
Questions
may be directed to Provider Services at 1-800-835-4080.