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Elizabeth M. Whitehorn, Director

Provider Notice issued 04/05/06

Illinois Cares Rx and Dual Eligible Enrollment Changes

To: ​Participating Pharmacies
​Date: ​April 5, 2006
​Re:
Illinois Cares Rx and Dual Eligible Enrollment Changes

 

Illinois Cares Rx members who were not in a Medicare Advantage plan were auto-assigned by HFS to one of the coordinating stand-alone plans, United Healthcare's AARP MedicareRx Plan (Plan Number S5820/016) and the PacifiCare Saver Plan (Plan Number S5921/082 ). Members have the right to switch plans if they prefer a plan other than the one they were assigned to. Many members have exercised their right to switch to a different stand-alone plan.

Additionally, Illinois Cares Rx members who were not assigned in the initial auto-assignment, or dual eligibles (Medicare and Medicaid eligible) who may not have initially been assigned to a Part D plan, may also have subsequently been enrolled in a Part D plan.

If you have an Illinois Cares Rx member or dual eligible for whom you are unable to process a claim to the plan you billed in previous months, it is likely that the member has switched plans or has become newly enrolled in a Part D plan. If this happens, please do an E1 eligibility transaction to determine the member’s current plan and plan ID. If you do not get enrollment information for a Medicare and Medicaid dual eligible by using the E1 transaction, please contact Medicare at 1-800-medicare. If you do not get enrollment information for an Illinois Cares Rx member, please call the plans first:

PacifiCare: 1-800-797-9794

United AARP: 1-888-492-2952

If, after calling the plans, you are unable to determine current enrollment status for an Illinois Cares Rx member, please call the provider hotline at 1-800-842-1461.