ArchCare Advantage (I-SNP) Member Resources

Transition Process

As a new or continuing member of our plan, you may be taking drugs that are not on our formulary. Or you may be taking a drug that is on our formulary, but your ability to get it may be limited. For example, you may need prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to another drug we cover or request a formulary exception in order for us to cover the drug you currently take. To give you time to speak to your doctor about the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan.

For each of your drugs that is not on our formulary, or if your ability to get your drugs is limited, we will cover a temporary 30-day supply when you go to a network pharmacy (unless you have a prescription written for fewer days). After your first 30-day supply, we will not pay for these drugs, even if you have been a member for fewer than 90 days. Other conditions may also apply.

If you are a resident of a long-term care facility, we will cover a temporary 31-day transition supply, consistent with dispensing increment (unless you have a prescription written for fewer days). We will cover more than one refill of these drugs for the first 90 days you are a member of our plan. If you need a drug that is not on our formulary and you are past the first 90 days of membership in our plan, we will cover up to a 31-day emergency supply of that drug while you pursue a formulary exception.

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This page was last updated on Wed, 02/08/2023 – 21:13

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)