Redetermination form
Reconsideration Form
Part D late enrollment penalty reconsideration
Complete and send your form to:
Fax787-200-2858 or 1-866-763-9097
WriteMCS Advantage, Inc.Attention: Pharmacy DepartmentPO Box 191720San Juan, PR 00919-1720
For assistance on how to complete these forms, you may contact our Customer Service Call Center at 787.620.2530 (Metro), 1.866.627.8183 (Toll Free) o TTY 1.866.627.8182 (Telephone for persons with hearing or speech impairment) Monday through Sunday from 8:00 a.m. to 8:00 p.m.