National Alliance on Mental Illness
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Tips at the Pharmacy Counter for Dual Eligible and Low-Income Subsidy Beneficiaries Subject to Plan Reassignment
December 21, 2007
Of particular concern to NAMI are individuals who are dually eligible for both Medicare and Medicaid or who qualify for the Low-Income Subsidy (also known as “Extra Help”) and are enrolled in a different plan for 2008. CMS has taken steps to ensure that there is no gap in overall prescription drug coverage or access to refills in January.
Any dual eligible or LIS recipient that received the blue colored reassignment letter from CMS needs to first read it carefully and contact their new prescription drug plan as soon as possible – every Part D plan is required to maintain an 800 customer assistance number.
It is critical to:
It is also critical that all physicians prescribing to the dual eligible or LIS individual be notified before January 1 of the plan switch. Likewise, the pharmacy that fills prescriptions for the dual eligible should be notified to see if they are part of the new plan’s network.
Finally, if possible, it is STRONGLY recommended for dual eligibles to obtain refills of as many medications as possible before January 1 to avoid problems at the pharmacy counter in the early days of January 2008 as enrollment in the new prescription drug plan in verified and new membership cards arrive in the mail.