Traditional MedicareReimbursementMedium impact
2024.64 - Provider Bulletin - Medicare Part D Co-pays for Dual Eligible HUSKY Low Income Subsidy Clients
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Effective January 1, 2025, Medicare Part D co-pays for dual eligible HUSKY clients are increasing: generic drugs from $4.50 to $4.90, and all other drugs from $11.20 to $12.15. HUSKY clients remain responsible for only the first $17 per month of Medicare Part D co-pays, and all claims must be submitted to Gainwell Technologies for proper tracking.
Action Required
By January 1, 2025: Pharmacy billing staff must update billing systems to reflect new Medicare Part D co-pay amounts ($4.90 for generics, $12.15 for other drugs) for dual eligible HUSKY clients. Ensure all Medicare Part D claims are submitted to Gainwell Technologies with Other Coverage Code 8 and Carrier Code MDD for proper $17 monthly co-pay tracking. Update system edits to reject co-pay only claims greater than $12.15 starting January 1, 2025.