If you paid for medications that should be covered by the plan, you can request a reimbursement.

Send us your request for payment, along with your bill and/or documentation of any payment you have made. Even if it is not a requirement, we suggest you fill out our claim form to make your request for payment. This form, which you can find below, will help us process the information faster, with all the information we need to make a decision. It’s also a good idea to make a copy of your bill and receipts for your personal records.

Once the form is completed, send your request for pharmacy reimbursement along with any invoices or receipts by mail or fax to the following address:

CVS Caremark Medicare Part D Claims
P.O. Box 52066
Phoenix, Arizona 85072-2066
Fax: 1-833-523-2629


You must submit your claim within a period of 12 months from the date when you received the service, item, or medication. When the request arrives to the plan, it must be processed within 14 calendar days. If the plan’s decision is favorable to you, the plan must make the payment within a period of 14 calendar days after receiving the request.

For more details on how to submit a claim in writing, you can refer to the Claims Process that is explained in Chapter 9 of the Evidence of Coverage of your plan.

For more information or help in submitting your request, you can contact Member Services.

Prescription Claim FormDownload

MMM of Florida, Inc. is an HMO plan with a Medicare contract. Enrollment in MMM of Florida, Inc. depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. MMM of Florida, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MMM of Florida Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-212-9858 (TTY: 711). MMM of Florida Inc. konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-844-212-9858 (TTY: 711).


Updated: December 2019

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