PACE

PROVIDER BULLETIN

December 31, 2008

Medicare Part D Plans

Effective January 1, 2009, approximately 138,000 PACE/PACENET cardholders will be enrolled in Part D partner plans. Although 4 of the 5 Partner plans are the same as last year, some cardholders may have been moved into a different plan that better serves their needs.

To ensure that the correct Part D plan is being billed as the primary, PACE is providing this list of all cardholders currently enrolled in the selected Medicare Part D plans who frequent your pharmacy. This list contains the PACE cardholder’s name, PACE card number, the Medicare Part D insurer’s name, BIN and PCN and the cardholder’s ID, when available. Although every attempt was made to ensure the completeness and accuracy of this report, additions or changes made after the printing date may affect the accuracy of the data.

IMPORTANT: CCRX AND FIRST HEALTH PREMIER HAVE NEW BINS AND PCNS FOR 2009. The November 2008, list contained the BIN’s and PCN’s used by these plans in 2008.

Partner Part D Plans	BIN	PCN	Mail Order	Prem	Deduct	Tier 1 Generic	Tier 2 Prefer’d Brand	Tier 3 Non-Prefer’d Brand	Tier 4 Specialty
AmeriHealth Advantage (IBC) Rx Option 1	012353	03660000	Walgreens Mail Service: 1-month or 34 day supply	$28.60	$295	25%	25%	25%	25%
MemberHealth Community CCRx Basic	610211	PDP	NO Mail Order— 90 day supplies available at retail	$25.40	$295	$0	30%	45%	NA
RxAmerica Advantage Star Plan	012189	5000	RX America; Escalante Solutions 90 day supply available at retail.	$27.80	$295	$5.50	25%	25% .	45%
Coventry First Health Premier	610014	MEDD PRIME	NO Mail Order— 90 day supplies available at retail.	$28.70	$0	$7	$27	$52	33%
UHC AARP Medicare Rx Saver	610097	9999	Walgreens; WHI RX Solutions	$22.40	$295	$5	$22.00	$60.05	25%

Provider Questions may be directed to Provider Services at 1-800-835-4080.