rx coverage for one month for dual eligible not enrolled in pdp?

[Special Agent]

I have a full medicaid prospect T65 starting part B 7/1/24 but was not enrolled in part A automatically because does not have the 40 quarters .She applied for part A yesterday at local SS office but she is concerned about rx cost for the month of july.I know in the past that full dual/lis who were not enrolled in part d were able to get drugs covered but i can't remember if it was a state program or federal program that paid or but this case may be different since she doesn't have LIS yet because of no part A to qualify for PDP.any suggestions?

 

[DonP]

I have a full medicaid prospect T65 starting part B 7/1/24 but was not enrolled in part A automatically because does not have the 40 quarters .She applied for part A yesterday at local SS office but she is concerned about rx cost for the month of july.I know in the past that full dual/lis who were not enrolled in part d were able to get drugs covered but i can't remember if it was a state program or federal program that paid or but this case may be different since she doesn't have LIS yet because of no part A to qualify for PDP.any suggestions?

That doesn’t matter . If she’s on Medicaid she 100% has a pdp card right now .What good would Medicaid be with no rx coverage ? It’s like when you run into a 55 yr old on ssi and Medicaid . They have a stand alone pdp card .

 

[hockeyday]

That doesn’t matter . If she’s on Medicaid she 100% has a pdp card right now .What good would Medicaid be with no rx coverage ? It’s like when you run into a 55 yr old on ssi and Medicaid . They have a stand alone pdp card .

If the have LIS they have a drug plan , either she picked one or got assigned one

 

[DonP]

If the have LIS they have a drug plan , either she picked one or got assigned one

Correct. If your on Medicaid your automatically on lis

 

[n3417511]

Yes she can get a 30 day temporary RX from Humana whom administers most of them. From what I’ve seen, the pharmacy helps them apply for it. Why don’t you go to Humana website and search for temp Rx for duel eligible. The social security office will backdate her A but she needs A to join so if it’s not showing up yet, Humana won’t give her a temp drug card for the month of July. I do believe her local retail pharmacy will no what to do. Hopefully she goes to a big pharmacy like CVS or Walgreens

 

[n3417511]

I guess she can get on part D with B only. Yes she can get a temp drug card for 30 days. Have her contact the pharmacy about her fuel eligible status. If she doesn’t have any luck on that, I can research the phone number for her to call. It’s funny because I just saw one last week whom had to do it that way for a month when she was removed from DSNP plan. This is happening a lot now

 

[n3417511]

Yes they have LIS status and are suppose to be issued a card automatically but you know how government runs. Very slow indeed

 

[Fisher]

I guess she can get on part D with B only.

No guessing about it, actually.

 

[Special Agent]

That doesn’t matter . If she’s on Medicaid she 100% has a pdp card right now .What good would Medicaid be with no rx coverage ? It’s like when you run into a 55 yr old on ssi and Medicaid . They have a stand alone pdp card .

I get referrals from a local mom and pop pharmacy and they could not fill her drugs because she T65 and started medicare in july but problem is because she lacked 40 quarters she was enrolled in part B only which is strange.

I have seen were a full dual was disenrolled from a snp plan because of out of area disenrollment when mail was returned to carrier.In this case they are disenrolled and it can be a month or two before they are auto enrolled in PDP.Last time this happened to one of my clients they were able to get some type of temporary drug coverage and thats what i was trying find out.

 

[DonP]

I get referrals from a local mom and pop pharmacy and they could not fill her drugs because she T65 and started medicare in july but problem is because she lacked 40 quarters she was enrolled in part B only which is strange.No part A-No PDP

I have seen were a full dual was disenrolled from a snp plan because of out of area disenrollment when mail was returned to carrier.In this case they are disenrolled and it can be a month or two before they are auto enrolled in PDP.Last time this happened to one of my clients they were able to get some type of temporary drug coverage and thats what i was trying find out.

I just went thru this . 3 yr client age 58 full dual got his part A and B dropped as he lost disability . He kep his Medicaid . He called ss and got his Medicare and disability back . I was checking Marx to see it . He was being disenrolled from United . Right when it popped up like June 26 th I called United to tell them don’t disenroll he got his his A and B back . They halted the disenrollment . But I checked Marx July 1 and there was his pdp card like he got disenrolled from his dsnp . So they did issue that pdp card fast on this