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Decrease Text SizeProblems and Solutions for Extra Help Beneficiaries
This CMS Tip Sheet (December 2007) describes the 2008 point-of-sale enrollment solution for Extra Help beneficiaries who discover at the pharmacy that they do not appear to be enrolled in a Part D plan.
This solution, called Point of Sale Facilitated Enrollment, (or POS) can be used by pharmacies to enroll them into a WellPoint Part D Prescription Drug Plan (PDP) so that their prescriptions can be filled.
As new enrollees, individuals enrolled through POS should recieve transition fills of any Part D drugs not on the WellPoint plan formulary, or on the formulary, but subject to utilization management requirements including prior approval, step therapy, or quantity limits. Remember that Extra Help beneficiaries have an ongoing Special Enrollment Period, allowing them to switch plans as frequently as monthly if their plan does not meet their needs.
This Tip Sheet from CMS (April 2007) for Medicare beneficiaries, including Extra Help beneficiaries, in Part D plans on how to resolve various problems encountered.
Updated Point of Sale Materials (April 2008)
Well Point made available updated information for pharmacists about Point of Sale Facilitated Enrollment (POS) in April 2008.
POS Pharmacy 4-Step Point of Sale Procedure
