Pennsylvania PACE

Wednesday, March 04, 2015

Complete and Submit your enrollment application online using the Enrollment Express Wizard!
Download / View the PACE/PACENET Enrollment Form and Instructions (PDF format)
Download / View the PACE/PACENET Enrollment Form Instructions (PDF format) in Español
(Bajar/Ver Pace Instrucciones de Nueva Inscripcion de Pace) (PDF Formato)
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

PACE/PACENET MAXIMUM INCOME LIMITS
	PACE:	Single:	$14,500	Copay Generic	$6
		Married:	$17,700	Copay Single-Source Brand	$9

	PACENET:	Single:	$23,500	Copay Generic	$8
		Married:	$31,500	Copay Single-Source Brand	$15

Effective January 1, 2015 PACENET cardholders not enrolled in a Part D Plan will pay a $33.91 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 2015

Contract # PBP Provider Name Plan Name Premium Deductible

S5601 012 SilverScript Choice Plan $22.00 $0

S5967 143 WellCare Classic Plan $32.50 $320 (Tiers 2 - 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...

Click Here

Looking for the lowest prices on your prescriptions? Click on the Link below for Informative Brochure on finding the lowest Cost Medications...

Click Here

Get the latest information on this year’s flu and the availability of flu shots...

Click Here

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.

Click Here to go to 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.

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