SWITCHING TO ANOTHER PRESCRIPTION DRUG PLAN

Why would a dual eligible switch from one plan to another?

A PDP may take a drug off its formulary or a dual eligible may be required to take a new drug that is not on the PDP’s formulary.

What happens if a dual eligible wants to switch to another prescription drug plan (PDP)?

Dual eligibles are permitted to change to another PDP at any time.  However, changes in a PDP will go into effect only on the first day of each month.  For example, if the parents of a dual eligible decide on January 2 that their child would be better served by a different PDP, the parents can call to make the switch on January 2 by calling 1-800-MEDICARE (1-800-633-4227).  However, the change will not go into effect until February 1.

 

What is the best way to switch PDPs?

Switching PDPs can be done by either enrolling in the new drug plan or by dis-enrolling from the current drug plan and then enrolling into the new PDP.  It is strongly recommended that whenever dual eligibles want to switch from one drug plan to another, they simply enroll in the new PDP – without doing a separate dis-enrollment.  By enrolling in the new PDP, there will be an automatic dis-enrollment from the previous plan.