ArchCare Advantage (I-SNP) Member Resources
Pharmacy Access Information
ArchCare Advantage has contracts with pharmacies that equals or exceeds CMS requirements for pharmacy access in your area. We have a national network of more than 62,000 pharmacies, with more than 400 network pharmacies in our service area. To find a pharmacy near you use our online search tool by clicking here. If you want a Pharmacy Directory mailed to you, or if you need help finding a pharmacy, please call 1‑800‑373‑3177. You may also email your request for the directory at email@example.com.
Filling your prescriptions when you travel or are outside of the plan’s service area.
We encourage you to use our network pharmacies at all times to fill your prescriptions. If you take a prescription drug on a regular basis and you are going on a trip, be sure to check your supply of the drug before you leave. We cannot pay for any prescriptions that are filled by pharmacies outside the United States, even for a medical emergency. We will cover your prescription at an out-of-network pharmacy, if you are unable to get a covered drug in a timely manner within our service area because there are no network pharmacies within a reasonable driving distance that provide 24-hour service or if your are trying to fill a covered prescription drug that is not regularly stocked at an in-network pharmacy (these include certain types of specialty drugs). You will need to pay out of pocket for these drugs and then submit a paper claims to us for reimbursement.
How do I submit a paper claim?
When you go to a network pharmacy your claim is automatically submitted to us by the pharmacy. However, if you go to an out-of-network pharmacy for one of the reasons listed above, the pharmacy may not be able to submit the claim directly to us. When that happens, you will have to pay the full cost of your prescription.
To submit a paper claim, you must send us a copy of the receipt for the prescription from the out-of-network pharmacy along with a completed paper claim form. Please send your paper claim to Medicare Part D Paper Claims, PO Box 52066, Pheonix, AZ 85072-2066. For more information, you may call us at 1‑888‑816‑7977, 24 hours a day, seven days a week. For TTY, call 711.
Paper Claim Form
To view, please download a copy here:
This page was last updated on Sat, 11/07/2020 – 09:29
ArchCare Advantage HMO SNP is a Coordinated Care Plan with a Medicare contract. Enrollment in ArchCare Advantage depends on contract renewal. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact ArchCare Advantage. This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care. Limitations, copayments and restrictions may apply. Eligible beneficiaries may enroll in our plan at any time of year. You must continue to pay your Medicare Part B premium. Benefits, formulary, pharmacy network, premium and/ or co-payments/co-insurance may change on January 1 of each year.
This information is available for free in other languages. Please contact our customer service number toll-free at 1-800-373-3177, seven days a week, 8 a.m. – 8 p.m. (TTY/TDD: 711). Esta información está disponible gratis en otros idiomas. Por favor llame a nuestro número de servicio al cliente al 800-373-3177, TTY 711, de domingo a sábado, de 8:00 am-8:00 pm.
Discrimination is Against the Law
ArchCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ArchCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1 800-373-3177 (TTY: 711).
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電1 800-373-3177 (TTY: 711)