abarca health performs the full suite of pharmacy benefit management (PBM) services for Puerto Rico’s Automobile Accident Compensation Administration, the Administración de Compensaciones por Accidentes de Automóviles (ACAA). As PBM for the prescription drug coverage offered by ACAA, abarca health is responsible for providing the following services: claims processing and adjudication; formulary management; development and maintenance of the Maximum Allowable Cost (MAC) List for generic drug products; and pharmacy network management services, among other services.
Pharmacy Services Help Desk (for beneficiaries/injured drivers and pharmacists) 1-866-224-0176 – Injured drivers who become ACAA beneficiaries and pharmacists should call abarca health‘s toll-free 24/7 Pharmacy Services Help Desk for specific questions regarding coverage of specific drugs, rejected claims, Drug Utilization Review (DUR) messaging, and other pharmacy-related questions.
Important resources on this page: ACAA beneficiaries and pharmacy providers will find important resources on this page. In order to access these resources, please click on the links below.
Pharmacy Services Help Desk 1-866-224-0176
ACAA Pharmacy List List of pharmacies that serve ACAA.
Prescription Drug Reimbursement Form ACAA beneficiaries should use this form to request reimbursement for drugs for which they have had to pay the full costs because of filling prescriptions at pharmacies that are not part of abarca health’s network or not having the ACAA beneficiary ID Card in their possession when filling prescriptions. You may fax your completed Claim Reimbursement Form/request for reimbursement by fax to ACAA’s Pharmacy Department fax number: (787) 274-8166 (attention Pharmacy Department).