OG Medicare Medicaid and PDP question

[vic120]

I have someone who is on Medicaid & Medicare, Wanted to go back to OG medicare buy Purchasing Drug plan.

I checked on medicare.gov showed Silver Script as $0 premium with Medicaid, However, after doing the plan received a bill for full premium. I did put all Medicaid Info on App. Why should they receive full bill do they pay and get reimbursed how does it work with Medicaid?

He Had full dues plan has full Medicaid.

 

[TwoCents]

I have someone who is on Medicaid & Medicare, Wanted to go back to OG medicare buy Purchasing Drug plan.

I checked on medicare.gov showed Silver Script as $0 premium with Medicaid, However, after doing the plan received a bill for full premium. I did put all Medicaid Info on App. Why should they receive full bill do they pay and get reimbursed how does it work with Medicaid?

He Had full dues plan has full Medicaid.

I suppose it's possible CMS doesn't have record of the Medicaid and the client would need to submit "best available evidence" to the carrier so they can work on getting the record updated on his behalf. When you say the client is on a Medicaid Medicare, I assume you mean one of those Medicare Advantage plans (not dual SNP) that has Medicaid built in that's run by carriers for the state? Did client lose Medicaid and you're not aware of it? Is client part of a spend down program?

 

[vic120]

I suppose it's possible CMS doesn't have record of the Medicaid and the client would need to submit "best available evidence" to the carrier so they can work on getting the record updated on his behalf. When you say the client is on a Medicaid Medicare, I assume you mean one of those Medicare Advantage plans (not dual SNP) that has Medicaid built in that's run by carriers for the state? Did client lose Medicaid and you're not aware of it? Is client part of a spend down program?

No, he was on Duel Complete with AARP but was having an issue with preauth and network

Paid $0 for everything even hospital meds all under $10 for expensive names and all

Had Medicaid card I included all info on app

 

[vic120]

Surprisingly I was able to speak with Silver Script the same day I put in a request, Said they accidentally sent that letter out and a new letter showing $0 premium will go out today