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Employer Name: PROGRESSIVE BENEFIT SOLUTIONS, LLC FSA Capital Expenditure FORM (03×2014) Last Firs t Employee Name: Street City Address: : MI State SS# Zip Phone: () Please check if this is a new
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How to Fill Out PBSCard:

01
Start by gathering the necessary information. You will need your personal details such as your name, address, contact information, and date of birth. Additionally, you may need to provide information about your insurance coverage or any prescription assistance programs you are enrolled in.
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Visit the PBSCard website or contact their customer service for the application form. The application form is typically available online and can be downloaded or filled out electronically. Alternatively, you may request a physical copy of the form to be mailed to you.
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Carefully read and follow the instructions on the application form. Make sure to fill in all the required fields accurately and provide any supporting documentation if requested. Double-check your entries for any errors or missing information before submitting the form.
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If you are applying online, submit the completed application electronically. If you are applying by mail, ensure that you have included all the necessary documents and postage before sending it to the designated address.
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After submitting your application, it may take some time for PBSCard to review and process it. Be patient and wait for a response from them. They may contact you if they need any additional information or clarification.
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If your application is approved, PBSCard will issue you a membership card or provide you with a membership number. Keep this information safe and easily accessible as you may need it when filling prescriptions or accessing discounts.

Who Needs PBSCard:

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Individuals with limited or no prescription drug coverage may benefit from PBSCard. It provides access to discounted medication prices and helps reduce the overall cost of prescriptions for those who are uninsured, underinsured, or facing high deductibles.
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Seniors who are enrolled in Medicare and the Medicare Part D program can also use PBSCard to supplement their drug coverage. It can help lower out-of-pocket costs for medications not covered by their existing plan or when they enter the coverage gap (also known as the "donut hole").
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People who are not eligible for government-funded prescription assistance programs but still require financial assistance for their medications can find value in PBSCard. It offers savings on a wide range of prescription medications and may be a helpful resource for those struggling to afford their essential drugs.
Remember, it is always best to review the specific eligibility criteria and guidelines provided by PBSCard to determine if it is the right fit for your individual needs.
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