PA Applications
These are the three ways someone can submit an application to Prescription Advantage.
What are online, paper application, and over the phone?
If an applicant filed taxes for the previous calendar year, they must submit this document.
What is the most recently filed federal income tax return 1040 or 1040SR?
This is another name for Low Income Subsidy (LIS).
What is Extra Help?
These are the 4Rs of PA.
What are Reactivation, Recalculation, Redetermination, and Reconsideration?
If you are emailing a pharmacy issue to pa_forms_inquiries@uhealthsolutions.org, you must mark the email as "High Importance" if the member has this much medication left.
What is a 4-day supply or less?
True or False: A social security number is required on the application.
What is False?
If an applicant doesn't file federal income taxes, they must complete this instead.
What is a self-attestation form?
This is the asset limit for LIS in 2024.
What is $17,220 (single) or $34,360 (married)?
An applicant who wants to reapply after being denied more than 15 days ago must do this.
What is complete a Reactivation application?
You can view all changes that were made on the member’s account (demographic updates, authorized representative being added/removed, mailings that were sent, etc.) by checking here in BEES.
What is the Event History tab?
These documents are sent to an applicant who applies over the phone.
What are the yellow pend letter and the pre-filled form?
This document will never be accepted for calculating income.
What are state tax returns?
A person has deemed status (automatically qualifies for Extra Help) if they have one of these.
What are both Medicare and Medicaid, a Medicare Savings Program, or both Medicare and SSI?
You can check here to see if a member was sent a letter requesting Redetermination.
What is the Letters tab under Event History in BEES?
An applicant must call this phone number to apply for the Medicare Savings Program.
What is 1-800-841-2900 (MassHealth)?
You must do this in order to submit income documents through PA's website.
What is register and submit an application?
An applicant/member who is no longer receiving alimony must send this document to have the income removed from their income calculation.
What is a copy of the divorce decree outlining details of alimony including end date or a letter from the provider of alimony payments indicating the date the payments ended?
These are the LIS documents you must save in the X:drive.
What are the LIS Receipt and the LIS Cover Letter?
This is needed in order to complete a Recalculation for a member who files federal income taxes.
What is a written request and a 1040 or 1040SR federal income tax return?
Pharmacists must verify this information if they are calling on behalf of a PA member.
What is their name, Pharmacy name, and phone number as well as the member's name, address, date of birth, and PA ID#?
When completing an application over the phone, since you are completing the form for the applicant, enter this for the "Name" and this for the "Role of the person completing the application".
What are "Not Applicable" and "Unknown"?
If a member's spouse passes away and they filed a joint federal tax return, we would need these documents to remove the income that belonged to the spouse.
What are the Social Security Benefit Letter, SSA-1099, or Social Security COLA as well as the 1099's and W2's for the spouse?
Once an LIS application is started, you must provide the applicant with this in case the call disconnects or they cannot finish the application at that time.
What is the re-entry number?
If PA learns about a member's death, E&E will mail this to the member's spouse if the spouse is also a member.
What is a "surviving spouse" letter?
A member with a household size of 2 and an annual income of $110,000 would fall into this category if eligible.
What is none?