Dual eligibles enrolled in certain Medi-Cal Home and Community-Based Services (HCBS) should have no copays for Part D drugs. This is thanks to the Affordable Care Act’s expansion of Medicare’s Part D Low-Income Subsidy (LIS) program, also known as Extra Help. Yet between 2012-2020, dual eligible beneficiaries in California’s Community Based Adult Services and those in San Mateo’s Multipurpose Senior Services Program (MSSP) were improperly charged copays. The Centers for Medicare and Medicaid Services and California’s Department of Health Care Services have been working together with Medicare Advantage and Part D plans correct the systems and get refunds back to those improperly charged for Part D drug costs. About 30,000 beneficiaries should have received refunds as of January 18, 2021.
For more information, see our partner’s Justice in Aging’s full summary.