Just want to confirm
- Thread starter billyb
- Start date
straightnochaser
Guru
- 549
No - She has 63 days
ValeRosso
Guru
- 524
Not unless she has creditable coverage Jan wont work. Shed need part d on Dec 1 or earlier.
I'm assuming when you say "10/1 Medicare effective date" that all eligibility (Part A, B, D) starts 10/1 so we're in the IEP. The clock starts at the end of the IEP so if the client wanted to play games, then yes, coverage could start 1/1.
From CMS:
The Part D plan sponsor shall use the Beneficiary Eligibility
Query (BEQ) or Common UI and other available information to determine whether
there is a lapse in creditable prescription drug coverage of 63 continuous days or
more since the end of his/her prior Part D/RDS enrollment, IEP, or subsequent IEP.
From CMS:
The Part D plan sponsor shall use the Beneficiary Eligibility
Query (BEQ) or Common UI and other available information to determine whether
there is a lapse in creditable prescription drug coverage of 63 continuous days or
more since the end of his/her prior Part D/RDS enrollment, IEP, or subsequent IEP.
Is she in IEP? If she’s T65 in October, then her IEP ends on January 31 and she could even delay enrolling in a PDP until her IEP ends.
But there’s more to consider—is she willing to accept the risk that she might need a new medication between 10/1 and 12/31 that would not be covered at all? Given the prices of drugs compared to the PDP premiums, I think I’d choose to pay the premium to avoid that risk.
But there’s more to consider—is she willing to accept the risk that she might need a new medication between 10/1 and 12/31 that would not be covered at all? Given the prices of drugs compared to the PDP premiums, I think I’d choose to pay the premium to avoid that risk.
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