Traditional MedicareReimbursementMedium impact
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, 2019
We identified it
Jun 20, 2026
Summary
Medicare Part D co-pays for dual eligible HUSKY Low Income Subsidy clients are increasing effective January 1, 2019: generic drugs from $3.35 to $3.40, and all other drugs from $8.35 to $8.50. A new system edit will deny co-pay only claims greater than $8.50 with the message 'Co-pay only claim greater than $8.50 Not Allowed'.
Action Required
By January 1, 2019: Pharmacy billing teams must update systems to reflect new Medicare Part D co-pay amounts ($3.40 for generics, $8.50 for other drugs) and ensure all Medicare Part D claims for dual eligible clients are submitted to DXC Technology for processing. Do not manually calculate client co-pays or charge without system submission, as claims with co-pays over $8.50 will be denied.