Traditional MedicareReimbursementMedium impact
Medicare Part D Copays for Dual Eligible HUSKY Low Income Subsidy Clients pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Effective January 1, 2022, Medicare Part D copays for dual eligible HUSKY Low Income Subsidy clients increased to $3.95 for generic drugs and $9.85 for all other drugs. Claims with copays exceeding $9.85 will be denied, and all Medicare Part D claims must be submitted to Gainwell Technologies for proper tracking of the $17 monthly copay maximum.
Action Required
Immediately: Pharmacy billing staff must submit ALL Medicare Part D claims for dual eligible HUSKY clients to Gainwell Technologies for processing, even if Medicaid is secondary payer. Update billing system to flag any copays greater than $9.85 as these will be automatically denied with error message. Stop calculating client copays manually - let Gainwell's system track the $17 monthly maximum to prevent overcharging patients.