Guest guest Posted June 6, 2006 Report Share Posted June 6, 2006 FYI From: Hoffmaster, Bruce K Sent: Tuesday, June 06, 2006 3:59 PM To: Cochrane, Barbara E Subject: FW: [CNSW] mcr d When we have a chance we should walk this through together. Bruce From: Beth Witten Sent: Friday, June 02, 2006 10:47 AM To: CNSW@... Subject: Re: [CNSW] mcr d I just got this confirmed by CMS yesterday because others have wondered this too. Patients can have Medicare Part D plans and EGHPs. When they apply for Medicare Part D, the application asks if they have other drug coverage. When they go to the pharmacy, they would show their insurance and Part D cards. The pharmacist would bill following the Medicare coordination of benefits rules and insurance and patient payments would be accounted to the " true out-of-pocket " of $5,100 for 2006. For the Medicare secondary payer patient, the billing would go to the EGHP first and Part D second for the 30 month MSP period. The patient would pay whatever was left after these plans pay. Exceptions: If someone has a retiree plan and the employer is getting the 28% tax free retiree drug subsidy then the patient cannot have a Part D plan. They may be at risk of losing their health coverage if they sign up for Part D if their drug and health coverage are not available separately. If someone has VA, he/she can choose with each prescription whether to use the VA or Medicare Part D. Most likely, if the drug is on the VA formulary, it's in the patient's best interest to use the VA. However, if the drug is not on the VA formulary, he/she could use Part D to get that drug if it is on the Part D plan formulary. ***************************** Beth Witten, MSW, ACSW, LSCSW Medicare Modernization Program Manager National Kidney Foundation, Inc. www.kidneydrugcoverage.org From: Fairfax Wynne Sent: Friday, June 02, 2006 9:23 AM To: CNSW@... Subject: [CNSW] mcr d CNSW List Maintenance Information: To log off the CNSW listserv, click on this link and follow the instructions: http://www.kidney.org/professionals/CNSW/listservRemove.cfm ***************************** Ok, I admit it. I’m suffering from overload and memory deficits. Having said that, please humor me and answer this question, please: can you use mcr d with a private plan? For example, use the D to pay for the drug and the private to pay the co-pay. My rational self says no. my normal, irrational self says “sounds like a plan”. Fairfax R. Wynne, CMSW Nephrology Social Worker FMC-NA 1331 Union Avenue, Ste 101 Memphis, Tennessee 38104 fax Quote Link to comment Share on other sites More sharing options...
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