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How to fill out the 8008908170 Form online
Filling out the 8008908170 Form online is an essential step for accessing your prescription drug benefits through the Sav-Rx Advantage program. This guide will provide you with clear instructions on how to complete the form effectively, ensuring that you receive the medications you need at a lower cost.
Follow the steps to complete the 8008908170 Form successfully.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Start by providing your personal information in the Member Information section. Fill in your full name, member number, date of birth, and gender. Make sure to use clear handwriting if you are printing the form.
- Complete the Address section with your current address, city, state, and zip code. Ensure that your contact information is accurate, including your daytime and evening phone numbers.
- Provide your physician's information by entering their name and phone number in the designated fields. This assists the Sav-Rx team in verifying your prescriptions.
- If you are adding dependents, complete the Dependent Information section for each individual. Input their name, member number, date of birth, gender, and contact details.
- Indicate your payment method. Choose between enclosing a check or money order or providing credit card details, ensuring to include the cardholder's name, credit card number, and expiration date.
- Review the section regarding generic drug replacements. If you prefer to receive brand drugs, check the appropriate box and understand that you will be responsible for the full cost.
- Double-check all information for accuracy before saving your changes. Once you are satisfied, you may download, print, or share the completed form as needed.
Start filling out your 8008908170 Form online to take advantage of your prescription benefits today.
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