Special Program to Get Prescriptions Filled at Low Cost
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Are You Being Charged Full Price for Your Prescriptions?
If you have been filling your prescriptions at no cost, you may find you are suddenly being charged full price at the pharmacy. This happens when someone who has had prescription coverage through Medi-Cal becomes enrolled in Medicare. Once someone is covered by Medicare, their prescription coverage must come from Medicare. Med-Cal will no longer provide no-cost prescription coverage, even if you want it to continue.
About Medicare Prescription Coverage:
Medicare prescription coverage requires that each person be enrolled in a plan with drug coverage, either a separate drug plan or a Medicare Advantage plan with drug coverage. It also requires that everyone pays a small co-pay for their drugs.
Fortunately, a program called Extra Help greatly reduces the cost of drug coverage through Medicare. If you have had prescription coverage through Medi-Cal, you will automatically qualify for this program. Other persons new to Medicare may also qualify, but in some cases they need to apply. HICAP can help. When you transition from Medi-Cal coverage to Medi-Cal plus Medicare, it can take several months for Medicare records to reflect your status and for you to be enrolled in a drug plan.
What if you need to fill your prescriptions while you wait?
Fortunately, a program called LINET will help. LINET stands for Limited Income-Newly Eligible Transition program. You are eligible if you have had full Medi-Cal benefits (or have been approved for Extra Help in another way) and if you do not yet have a Medicare drug plan. LINET allows you to get your prescriptions filled at any pharmacy and pay no more than the applicable Extra Help co-pay. There is even retroactive coverage back to your eligibility date if you had to pay full price at the pharmacy. Call LINET directly or ask HICAP for assistance.
What do you need?
- You need written documentation that you are eligible for this low-income program. If you have had Medi-Cal, a Notice of Action showing your Medi-Cal status is most often used. If you don’t have written documentation, HICAP may be able to work with Medi-Cal to provide this to you. That “Best Available Evidence” can be sent to LINET via FAX on (877) 210-5592. Usually the pharmacy can help you do this
- In addition to your prescription, you will also need to provide your birth date, zip code, and Medicare number. If you do not yet have a Medicare card, you can get the number from Medicare at (800)-633-4227, or HICAP can contact Medicare for you.
- Tell the pharmacy staff you are new to Medicare and want to use LINET to fill your prescriptions. Not all pharmacies are familiar with this program, but LINET agents will help the pharmacy staff to fill your prescriptions. The LINET number for pharmacists or clients is: (800) 783-1307. Show them this note if necessary.
A PDF file on this topic can be found in the following link. You may view, print, or download our PDF document LINET: Transitioning to Medicare Part D with Extra Help.
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