Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 104 - MAINE STATE SERVICES MANUAL
Sec2 144-104-4 - Maine Part D Wrap Benefits
Subsection 144-104-4.04 - PARTICIPATION IN MEDICARE PART D WRAP BENEFITS

Universal Citation: 10 ME Code Rules ยง 144-104-4.04

Current through 2024-38, September 18, 2024

Participants must exhaust other pharmacy benefits including Medicare Part D and Maine Care before using benefits under this Section.

4.04-1 Authorized Representative

The Department may act as an authorized representative for or appoint a designee to act as an authorized representative for participants who are eligible for Medicare Part D.

As an authorized representative, the Department may:

a. deem eligible and enroll and reenroll participants in a Medicare Part D plan;

b. apply for Medicare Part D benefits and subsidies on behalf of enrollees;

c. establish rules by which enrollees may opt out of participation in Medicare Part D; and

d. at its discretion, file exceptions and appeals pertaining to Medicare Part D eligibility or benefits on behalf of enrollees.

4.04-2 Coverage of Drugs Excluded from Coverage under Medicare Part D

For participants who are eligible for Medicare Part D, the Department may provide coverage of drugs excluded by Medicare Part D to the same extent that coverage is available to participants who are not eligible for Medicare Part D.

Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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