C.M.R. 10, 144, ch. 104, § 144-104-4, subsec. 144-104-4.03

Current through 2024-51, December 18, 2024

Subsection 144-104-4.03 - ELIGIBILITY

An individual is eligible to receive services as set forth in this Section if he or she meets the eligibility requirements established in 10-144 C.M.R. Chapter 333, and adheres to the additional requirements outlined below. Some participants may have restrictions on the type and amount of benefits they are eligible to receive under this Section.

The Department will enter enrolled participants into its electronic database. Entry into the Department's electronic database may occur in one of three ways:

1. Auto-enrollment whereby the Department automatically enrolls the participant into an approved PDP and enters the participant into the Department's database; or

2. Self-enrollment by the participant into an approved PDP. Participants who self enroll must communicate their enrollment to the Department, at which time the Department will confirm the information and enter the participant into its database. Providers should inform participants to call the Department's toll free help line at 1-866-796-2463 to report self-enrollment; or

3. If the Centers for Medicare and Medicaid Services (CMS) enrolls Medicare Savings Program (MSP) participants into an approved PDP.

DEL and Part-D eligible Maine Care members can receive wrap benefits through any CMS approved PDP.

C.M.R. 10, 144, ch. 104, § 144-104-4, subsec. 144-104-4.03