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TTY: 711
Care Improvement Plus
National Home Providers Medicare Part D PA Coverage Review

Online PA Coverage Review

Because your time is as precious as it is scarce, Medco has put its coverage review process online. You or your designated staff member can log onto www.medco.com/coverage to initiate or complete a coverage review–at your convenience, anytime, day or night.

Call today to activate your PIN.

You recently received a letter that provided a PIN for your practice, as well as instructions for getting your temporary password. If you haven't activated your PIN, please do so today by calling 1-800-496-5661. If you haven't received the letter or if you've misplaced your PIN, we can give that to you when you call.

Your patients' privacy is protected.

Only you and those you authorize can use the PIN to create a password and access the site. Be sure to keep your PIN and password(s) in a safe place. All of us at Medco hope you'll enjoy this fast, convenient alternative to phone-based coverage reviews. If you have any questions, please call Medco's prescriber PIN and password support line at 1-800-496-5661.

Frequently Asked Questions

How long does the process take?
Depending on the speed of your Internet service, the coverage review process should take no longer than 2 or 3 minutes.

Who will have access to my patients' personal health information?
You decide who can provide the additional information that Medco needs to determine coverage eligibility. You can restrict access to yourself, or you can assign one or more staff members to conduct the reviews.

Are online coverage decisions made faster?
Medco will continue to quickly make coverage decisions based on the patient's prescription drug plan. We can begin our part of the coverage review process as soon as we receive the additional information we need from you.

Can we continue to conduct coverage reviews by fax or phone?
Yes. If you find the online coverage review process to be less convenient, by all means, continue to fax or call Medco to process coverage reviews.

Will my PIN expire?
No. PINs don't expire. However, passwords expire every 90 days. If your password expires, you'll be prompted to create a new one the next time you log on to the website.

When I log on to the website, are the PIN and password case-sensitive?
Yes. PINs and passwords are case-sensitive.

Can I create a new coverage review case for any of my patients?
You can create a new coverage review case only if there's a recent rejected pharmacy claim on file for that specific patient. If you attempt to create a new coverage review case and there are no recent rejected claims on file for that patient, you'll receive a message indicating that no recent rejected claim could be found. You will then be directed to call Medco for further assistance.

What information do I need to complete a coverage review online?
You'll need the patient's member ID number and date of birth.

What are the hours of operation of the PIN and password support line?
Help is available from 8:00 a.m. to 9:00 p.m., Eastern Time, Monday through Friday.



This page was last updated on: 11/30/2011 11:58:21 AM

Copyright © 2006 - 2012 Care Improvement Plus
Y0072_OE12_4511 CMS Approved 11/15/2011

Care Improvement Plus is a Medicare Advantage organization with a Medicare contract. The Care Improvement Plus contract with CMS is renewed annually and coverage availability beyond the end of the current contract year is not guaranteed. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2013.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. For more information contact the plan. To be eligible for a Care Improvement Plus plan you must be a Medicare beneficiary living in Arkansas, Georgia, Missouri, South Carolina, Texas and select counties in Illinois, Iowa, Indiana, Maryland, New Mexico, New York, Wisconsin and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Chronic Conditions Special Needs Plan, you must have diabetes and/or heart failure. To be eligible for Care Improvement Plus Dual Advantage, you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing.

Members may enroll in the plan only during specific times of the year. Contact Care Improvement Plus for more information. If you have diabetes, heart failure, or Medicaid/Low Income Subsidy, you may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a “Special Election Period.

You must continue to pay your Medicare Part B premium. If you are a full benefit dual beneficiary and your Part B premium is paid for by the State, you will not be responsible for paying your Part B premium. Premiums, copays, coinsurance and deductibles may vary based on the level of help received. Limitations, copayments and restrictions may apply.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 1–800–MEDICARE (1–800–633–4227). TTY users should call 1–877–486–2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1–800–772–1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1–800–325–0778; or
  • Your State Medicaid Office.

People with limited incomes may qualify for extra help to pay their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office, or call Social Security at 1–800–772–1213.TTY users should call 1–800–325–0778. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp. If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a part of this premium, we will bill you for the amount that Medicare doesn’t cover.

Premiums, copays, coinsurance, and deductibles may vary based on the level of help that beneficiaries may receive. Contact the plan for further details. Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under nonroutine circumstances, and quantity and restrictions may apply. It may cost more to get care from out–of–network providers, except in an emergency. If there isn’t a network provider available for you to see, you can go to an out–of–network provider but still pay the in–network amounts except for members who live in our Maryland service areas. Those members can only use doctors, specialists, or hospitals in–network. The health providers in our network can change at any time.