Dave Munroe at the Springfield Center for Independent Living was contacted by a person with a disability who lost coverage under an Integrated Care Plan under Medicaid. It turns out that the individual had recently become eligible for Medicare coverage under their deceased spouse’s Social Security record. As such, this person should have been transferred from the ICP plan under Medicaid to the comparable plan under the Medicare Medicaid Alignment Initiative (MMAI). This did not happen, however.
The individual was not notified that their ICP coverage was going to end and would not have found out had they not tried to fill vital medications only to be told that they had no coverage. Mr. Munroe aided this person in contacting Client Enrollment Services and ensured that the person was enrolled in the same type of plan under MMAI. The immediate issue here is that the new coverage will not start until July 1, 2015, leaving the individual with a Medicare Part D plan in which they were auto enrolled and which does not cover their most important medications. In the end, comparable medications were found which will likely get the person through the month with no other coverage, but the urgency arising from this situation was unnecessary, had this person been contacted about ICP coverage ending. If there had not ended up being alternate medications, the retail cost of the two scripts needed at the time would have totaled $875.00, more than the individual receives from Social Security. With the previous coverage and the future coverage, the two medications would cost the individual absolutely nothing!