At Priority Health, we want to make sure you get the help you deserve with your Medicare prescription drug costs. That’s why we follow the Best Available Evidence (BAE) policy from the Centers for Medicare & Medicaid Services (CMS).
What is BAE?
Sometimes, the information CMS has about your eligibility for Extra Help (also called the Low-Income Subsidy or LIS) might not be up to date. This can affect how much you pay for your medications.
The BAE policy allows us to use the most accurate and current information, like a Medicaid card or a letter from Social Security to assess eligibility. Even if CMS’s records haven’t caught up yet, this policy helps to make sure you’re paying the correct amount for your prescriptions.1
Why It Matters
If you qualify for Extra Help, you could pay much less for your medications. But if CMS doesn’t have the right information, you might be charged more than you should. That’s where BAE comes in, to help us quickly correct that.
What You Can Do
If you think you are being charged too much but qualify for Extra Help
- Gather your documents—this could be a Medicaid card, a letter from Social Security, or other proof of your eligibility.
- Share them with us—you can send us your information by faxing Medicare Enrollment at 616-942-7204.
- We’ll take care of the rest—once we receive the right documents, we’ll adjust your costs based on the BAE policy.
Need Help?
If you have questions or need help submitting documents, our Customer Care team is here to help. Contact our Customer Care team by calling the number on your member ID card or logging into your member account to send us a message. We’ll work with you to make sure you’re getting the savings you’re entitled to.
1Source:Best Available Evidence (BAE) | CMS
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