Frequently Asked Questions
Part D Eligibility with Medicaid eligibility
Q : I have a client that is a dual eligible for Medicaid and Medicare. She has enrolled in a Medicare Part D Plan, but has not yet received her card and doesn’t know her information. Can’t we bill Medicaid for her drugs until her Medicare information becomes available?A: No. Medicaid cannot pay for Medicare covered medications for a dual eligible client. Medicare has set up the Wellpoint system to cover these situations. The pharmacy must use the Wellpoint system to obtain transitional coverage for a dual eligible client. Please refer to the February 2006 Amber sheet, available on this website for more information.