New Model Medicare Prescription Payment Plan documents

[Duaine]

Enrollee assistance data fields:

CMS is also adding two (2) new data fields to capture information about individuals who help applicants fill out the form. Individuals (for example, State Health Insurance Assistance Program counselors, agents, and brokers) must indicate if they helped the applicant fill out the form and must disclose their relationship to the applicant. Agents and brokers will also be expected to provide their assigned National Producer Number (NPN) if they assisted the applicant with completing the enrollment form. Previous versions of the model enrollment form requested information about individuals providing assistance to applicants completing the form, and this is a long-standing requirement codified in §§ 422.60(c) and 423.32(b). However, previous versions of the form did not request information about an individual’s relationship to the applicant and the agent or broker’s NPN.

 

[hockeyday]

Enrollee assistance data fields:

CMS is also adding two (2) new data fields to capture information about individuals who help applicants fill out the form. Individuals (for example, State Health Insurance Assistance Program counselors, agents, and brokers) must indicate if they helped the applicant fill out the form and must disclose their relationship to the applicant. Agents and brokers will also be expected to provide their assigned National Producer Number (NPN) if they assisted the applicant with completing the enrollment form. Previous versions of the model enrollment form requested information about individuals providing assistance to applicants completing the form, and this is a long-standing requirement codified in §§ 422.60(c) and 423.32(b). However, previous versions of the form did not request information about an individual’s relationship to the applicant and the agent or broker’s NPN.

They can call the insurance company or go to the pharmacy for help with this, the last thing an insurance agent needs to do is get involved in a payment plan

 

[Duaine]

But she needs me...! No internet, no phone, no iPad, no computer and can't read or write.

 

[InsuranceGuy29]

They can call the insurance company or go to the pharmacy for help with this, the last thing an insurance agent needs to do is get involved in a payment plan

Agreed. I have no idea how this system is gonna be. The absolute last thing I need is getting calls about their credit card not going through, or their payment amount was changed or malfunctioned, or they thought it was gonna be $25.50, and it's $25.75, or something like this. I can see the chaos already.

It's all stuff we don't have access to. There's no reason the pharmacy or company can't do this. It's their system. I always make it very clear my help is with insurance coverage policy issues.

This is just something I cannot help with, as I don't even have access to anything to do with payments or prices of anything. Payment plans are completely out of my control. That's up to the point of sale or whoever instituted it.

 

[TwoCents]

They can call the insurance company or go to the pharmacy for help with this, the last thing an insurance agent needs to do is get involved in a payment plan

Duaine (Original poster) didn't do a good job of explaining that he posted about 2 different things. For the 2025 MA/PDP enrollment form to join a plan (MA/MAPD/PDP) there's a new/returning box where agents will have to provide NPN.

Then there are the forms about the Medicare Prescription Payment Plan.

 

[hockeyday]

Duaine (Original poster) didn't do a good job of explaining that he posted about 2 different things. For the 2025 MA/PDP enrollment form to join a plan (MA/MAPD/PDP) there's a new/returning box where agents will have to provide NPN.

Then there are the forms about the Medicare Prescription Payment Plan.

I already provided my npn number on my apps, it's how I get paid