PHARMACY ACCESS INFORMATION
ArchCare Senior Life (PACE) 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 the “Pharmacy Locator” button in the right column.
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, Phoenix, AZ 85072-2066. For more information, you may call us at 1‑866-412-5435, 24 hours a day, seven days a week. For TTY, call 711.
PAPER CLAIM FORM
To view, please download a copy here: