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.