Wellcare PDP LEP Circus

somarco

GA Medicare Expert
5000 Post Club
36,602
Atlanta
Client enrolls online. Has confirmation number. Receives a CMS form "Declaration of Prior Prescription Drug Coverage". The form is to be completed and mailed back to your Medicare drug plan at (address not provided).

The "form" has check off boxes where you may declare if you had prior creditable coverage or not and from what source. Form is to be signed and dated.

Seems simple enough, but given the incompetence of #WellcarePDP I have strong reservations that it will be handled properly.

Is there any reason why this form, or a similar OFFICIAL CMS form, cannot be sent to Medicare? Or perhaps calling 800-MEDICARE direct?

At least the Medicare CSR's are US based . . . for now
 
Client enrolls online. Has confirmation number. Receives a CMS form "Declaration of Prior Prescription Drug Coverage". The form is to be completed and mailed back to your Medicare drug plan at (address not provided).

The "form" has check off boxes where you may declare if you had prior creditable coverage or not and from what source. Form is to be signed and dated.

Seems simple enough, but given the incompetence of #WellcarePDP I have strong reservations that it will be handled properly.

Is there any reason why this form, or a similar OFFICIAL CMS form, cannot be sent to Medicare? Or perhaps calling 800-MEDICARE direct?

At least the Medicare CSR's are US based . . . for now

The reason why the information can't be submitted to CMS is simply because CMS has put this work into the hands of the plan. Even when filing an appeal to the CMS contractor (MAXIMUS), neither MAXIMUS or CMS will update the creditable coverage history. Their determination is sent back to the plans to process and update CMS records. There's an entire chapter of the CMS Part D manual dedicated to creditable coverage/LEP.
 
Does anyone here believe Wellcare can get it right?
These things are audited by CMS so I'm thinking they get it right most of the time. haha I'm not going to bother to take the time to see if they've ever been fined for actions related to creditable coverage processing.
 
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