Caregivers

Checklist for Plan Enrollment

Prior to enrolling someone in your care into a PrescribaRx plan, please be sure to have the following information ready:

• Know which PrescribaRx plan best fits his or her needs
• Beneficiary's first, middle and last name (spelled correctly)
• Beneficiary's date of birth
• Beneficiary’s home phone number including area code
• Beneficiary’s permanent street address
• The mailing address to which all correspondence will be sent (this could be yours or the beneficiary’s)
• Emergency contact information (this could be you or another person)
• Beneficiary’s Medicare card
• Any additional medical or prescription plan information, if applicable
• Social Security or checking account information if premiums will be deducted directly from an account