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Get the free Medicare Part D Drug Claim Form - bcbsal.org

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Questions about completing this form? Call 18003273998 (AL) 18883117508 (TN) TTY: 711 8 a.m. 8 p.m. seven (7) days a week×Prime Therapeutics Medicare Part D Drug Claim Form Please complete each section
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Medicare Part D is a federal program that helps Medicare beneficiaries pay for prescription drugs.
Insurance companies or other entities that provide prescription drug coverage to Medicare beneficiaries are required to file Medicare Part D drug coverage.
One can fill out Medicare Part D drug coverage either online through the Centers for Medicare & Medicaid Services website or by mail using the paper form provided by the CMS.
The purpose of Medicare Part D drug coverage is to help Medicare beneficiaries afford prescription medications.
Information such as the list of covered medications, cost-sharing amounts, and formulary must be reported on Medicare Part D drug coverage.
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