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Medicare Part D Co-pays for Dual Eligible HUSKY Low Income Subsidy Clients pdf

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Starting January 1, 2023, Medicare Part D co-pays increase for dual eligible HUSKY clients - generic drugs increase from $3.95 to $4.15, and all other drugs increase from $9.85 to $10.35. Clients remain responsible for only the first $17 per month in co-pays, and all Medicare Part D claims must be submitted to Gainwell Technologies for proper tracking.

Action Required

Action needed
By January 1, 2023: Pharmacy billing staff must update billing systems to reflect new Medicare Part D co-pay amounts ($4.15 for generic drugs, $10.35 for all other drugs) for dual eligible HUSKY clients. Configure systems to automatically submit all Medicare Part D claims to Gainwell Technologies with Other Coverage Code 8 and Carrier Code MDD. Set system limits to reject co-pay only claims greater than $10.35. Stop manually tracking patient co-pays - let Gainwell system handle the $17 monthly maximum tracking.