PACE

Provider Bulletin

May 2, 2008

PACENET Premium for Additional IBC Plans

to be

Collected at Point of Sale

 

Effective for claims with a date of service of May 1, 2008, 6,800 PACENET cardholders enrolled in the following IBC Part D plans will have the Individual Plan’s Premium, up to the monthly premium benchmark of $26.59, collected at the point of sale:

 

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.