Using Medicare Prescription Drug Coverage Before Receiving a Drug Plan Membership Card

March 1 is here.... plan for new enrollees and plan switchers.

In the next few days, pharmacists will inevitably have to serve some Medicare beneficiaries who have enrolled in a plan or switched plans late in February. As a result, some of these beneficiaries may not yet be identified in pharmacy systems. As a reminder to pharmacists, we are once again sending instructions for using the eligibility (E1) functionality to check on plan enrollment and Medicare eligibility status. Per-Se Technologies has issued recommendations for optimizing the E1. For more information you may visit their Medicare Part D home page, or contact your software vendor.

For beneficiaries who are eligible for both Medicare and Medicaid but who do not appear to have been enrolled in a plan, we are also sending instructions for using the Point of Sale Facilitated enrollment process. This process, known as the "Wellpoint Point of Sale solution", will allow pharmacies to submit claims to Wellpoint for a dual eligible beneficiary who does not appear to be enrolled in a plan so the beneficiary will not have to leave the pharmacy without the medications they need. A FAQ document and instructions can be found at Anthem Prescription's Medicare Part D home page.