CMS Part D Enrollment Detail

WINDOW OVERVIEW:

The CMS Part D Enrollment Detail displays the Plan information for dual eligibles who are enrolled in a Part D plan.

The window opens when the Part D Enrollment button is selected on the CMS List window.

If there is no Part D enrollment information when the button is selected, the message will display on the task bar:

CMS File does not have Part D Enrollment Information for this person.

See also:

CMS Overview

FIELD DESCRIPTIONS:

Record Received: This field displays the Month/Day/Year that this record was received.

Record Month/Year: This field displays the Month and Year covered in this record.

CMS File Group Box:

Claim Number: This field displays the Medicare Claim number.

First Date Eligible: This field displays the date (Month/Day/Year) the person was first eligible for Part D whether or not they have actually enrolled in a plan.

Declined: This field shows an indicator when the person has declined Part D coverage.

Part D Enrollment History List Box:

This box displays the Plan assignment(s). Use the scroll bar to view the information on the right side of the window.

Start Date: This field displays the date (Month/Day/Year) the Plan enrollment began.

End Date: This field displays the date (Month/Day/Year) the Plan enrollment ended.

Company Name: This field displays the name of the Company offering the Plan.

Plan Name: This field displays the name of the Plan where the person is enrolled.

Enrollment Type: This field displays the type of Enrollment (i.e. Auto- Enrollment, Beneficiary Election, etc).

In some cases the Company Name and Plan Name may be in code. This may occur if the participant is enrolled in a Plan but the plan is not a valid plan for Nebraska. When information about this type of plan assignments is needed call N-FOCUS Production Support (1-888-281-6629 or 402-471-9698).

Part D CoPay History List Box:

This box displays the CoPay Level assigned to the participant by CMS.

CoPay Level: This column displays the CoPay level. The CoPay Levels are Low
Currently $1 or $3 , High
Currently $2 or $5 or None
Should only be valid for participants currently in a nursing home or IMD, or have been in one of those living arrangements during the calendar year.

Start Date: This field displays the date (Month/Day/Year) the CoPay begins.

End Date: This field displays the date (Month/Day/Year) the CoPay ends.

There may be a delay in the CoPay Level data being updated when there are changes in living arrangement that would impact the level such as a participant was living independently or in an alternate living arrangement who was subject to a Low or High copay enters a nursing home and is no longer subject to a copay. This delay is caused because of the monthly processing schedule.

The Medicaid Program pays the Medicare Part D copayments for clients exempted from Medicaid Copayments such as Alternate Living Facility Clients, Home & Community Based Waiver clients, Excess-income clients, children 18 and younger.

ACTION BUTTON:

Select the OK button to return to the CMS List window.

(02-2007)