May 28, 2009 4:43 PM
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ALERT! Important changes to Medicare Part D Prescription Drug Coverage in Effect Now
ATTENTION!
Important Changes to Prescription Drug Coverage for people on Medicare Part D
AND
Medicaid
or
ConnPACE (CT Pharmaceutical Assistance Contract to the Elderly and the Disabled)
or
CADAP (CT AIDS Drug Assistance Program)
At some point this week, if not already, you will receive a letter from the CT State Department of Social Services (DSS) notifying you of an important change in your Medicare Part D prescription drug coverage.
Currently, DSS pays for prescriptions that your Medicare Part D prescription drug plan does not cover on its formulary (its list of covered medications).
Beginning June 1, 2009, if your provider prescribes a drug for you that you are NOT currently taking, and that drug is NOT on your Medicare Part D Prescription Drug Plan's formulary, DSS WILL NOT pay for it.
DSS will continue paying for drugs you are currently taking until January 1, 2010, even if they are not on your Medicare Part D Prescription Drug Plan's formulary.
DSS is available to assist you with the exception process and will continue assisting pharmacies and providers with questions about your Medicare Part D Prescription Drug Plan. For assistance, contact the Pharmacy Unit at
(860) 424-4880, or toll free at 1-800-340-0715.
IMPORTANT INFORMATION FOR YOUR PROVIDER:
On and after June 1, 2009, if your provider prescribes a drug for you that you are not currently taking and that drug is not on your Medicare Part D Prescription Drug Plan's formulary, the pharmacist should contact your provider to discuss other drugs that are covered by your Medicare Drug Plan. Your provider may either change your prescription to a drug that is covered by your Medicare Drug Plan, or ask your Medicare Part D Prescription Drug Plan to grant an exception or authorization so that the drug will be covered. If it is medically necessary for you to receive the specific drug that is not covered by your Medicare Drug Plan, your provider must ask for this exception or authorization from your Medicare Part D Prescription Drug Plan, or call the DSS Pharmacy Unit at the number provided below.
DSS strongly encourages you and your provider to work within your Medicare Part D Prescription Drug Plan's formulary.
These changes will remain in effect for the remainder of the fiscal year, which ends June 30, 2009 OR until a new budget is passed (after the end of the fiscal year). The new budget may or may not include this policy change.
NAMI-CT WILL NOTIFY YOU IMMEDIATELY OF ANY UPDATES TO THIS POLICY CHANGE AS SOON AS THE INFORMATION BECOMES AVAILABLE.
ADDITIONAL INFORMATION FOR MEDICAID RECIPIENTS:
Medicaid recipients may always switch to another Medicare Drug Plan.
If you need help choosing a Medicare Part D Drug Plan that is right for you, please call:
1-800-MEDICARE (1-800-633-4227), or you may call CHOICES, your State Health Insurance Program (SHIP) at 1-800-994-9422. TDD/TTY users please call 1-877-486-2048.
FOR CADAP MEMBERS:
There are certain kinds of drugs that Medicare Part D will not cover such as barbiturates, benzodiazepines, some drugs used for weight gain, some drugs used to treat cough and colds, some prescription vitamins, and some non-prescription drugs (over the counter). CADAP will continue to cover some of these drugs for you, provided that they are on the CADAP formulary. When you go to the pharmacy to pick up your prescriptions, continue to show the pharmacist both your CONNECT card and Medicare Part D PDP card.
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