Pennsylvania PACE

Wednesday, December 19, 2018

Complete and Submit your enrollment application online using the Enrollment Express Wizard! Google Chrome works best if printing a hard copy of the submitted application.
Download / View the PACE/PACENET Enrollment Form and Instructions (PDF format)
Download / View the PACE/PACENET Enrollment Form and Instructions (PDF format) in Español
Complete Coordination of Benefits form regarding Health and Prescription Insurance (PDF format).

If printing documents, they can be mailed to PO Box 8806, Harrisburg, PA 17105-8806 or faxed to 888-656-0372.

PACE/PACENET WORKS WITH:

MEDICARE PART D PLANS

RETIREE/UNION COVERAGE

EMPLOYER PLANS

VETERANS' BENEFITS

PACE/PACENET will help save you copay dollars and out-of-pocket expense. It's easy! Simply take your PACE card and any other prescription ID cards to your pharmacy.

Need Assistance with PACE/PACENET?
Call 1-800-225-7223

Medicare Web Page - www.medicare.gov
Frequently Asked Questions about PACE and Medicare Part D in 2019
Letters Regarding Medicare Part D Assignments in 2019
Letters Regarding Auto Renewing Benefits in 2019
Part D Plans having Premium Payment Agreements with PACE for 2019
Learn about the PACE Outreach Program
Learn about the right way to throw away medicines
Pharmacy Provider Bulletins containing information on program policies and guidelines
Calculating your daily dose of pain medications. The Morphine Equivalent Dose Calculator calculates the total daily dosage of all opioids as equivalent to 1mg of Morphine. The calculator is courtesy of the Washington State Agency Medical Directors' Group.

PACE/PACENET Maximum Income Limits

PACE:

Single:

$14,500

Copay Generic

Married:

$17,700

Copay Single-Source Brand

PACENET:

Single:

$27,500

Copay Generic

Married:

$35,500

Copay Single-Source Brand

$15

Effective January 1, 2019 PACENET cardholders not enrolled in a Part D Plan will pay a $37.03 premium at the pharmacy each month.
Income qualification is based on prior year's income and includes taxable and non-taxable sources. Assets and resources are not counted as income.

Part D Partner Plans for 2019

Contract #

PBP

Provider Name

Plan Name

Premium

Deductible

S5601

012

SilverScript

SilverScript Choice (PDP)

$32.50

S4802

080

WellCare

WellCare Classic (PDP)

$34.80

$0 on Tier 1 and
$415 on Tier 2 thru 5

PACE/PACENET benefits are considered "creditable coverage" which means that the benefits offered through this program are as good as or better than the prescription benefits offered through Medicare Part D. However, we encourage individuals to be enrolled in PACE/PACENET and Part D together. By doing so, cardholders can potentially save even more money when buying their prescription medications, and it helps the PACE Program save money, too!

Not eligible to receive PACE/PACENET? Maybe the Pennsylvania Patient Assistance Program Clearinghouse can Help...
View the Pennsylvania Patient Assistance Program Clearinghouse brochure,
Apply to the Pennsylvania Patient Assistance Program Clearinghouse
or call 1-800-955-0989.

Looking for the lowest prices on your prescriptions?
View an Informative Brochure on finding the lowest Cost Medications

To apply for benefits, either click on Download / View to print a copy of the enrollment form, which can be mailed or faxed. Or, to apply directly online, click on Complete and Submit. To apply online, you must complete all of the applicable fields on the application. You will have the option to print the application at the end of the online application process.

Visit the Pharmaceutical Assistance Contract for the Elderly Page
The Department of Aging thanks you for visiting the PACECares web site.

No person or entity may use the PACE Program as an endorsement without prior written approval from the program.

Secure Personnel

Updated 12/13/2018