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Medicare Part D:
New Law Extends Emergency Medi-Cal Drug Coverage

Updated August 07, 2006

Medi-Cal Emergency Drug Coverage For People with
Medi-Cal and Medicare Drug Coverage Has Been Extended

California extended its Emergency Drug Benefit through January 31, 2007 for people who have both Medicare and Medi-Cal.

On January 1, 2006, about one million Californians dually eligible for Medi-Cal and Medicare had their drug coverage switched from Medi-Cal to private drug plans or HMOs offering the Medicare drug benefit. Many people affected by this change have experienced trouble getting their drugs through Medicare drug plans.

To help address these problems, California created the Emergency Drug Benefit to help cover the cost of medications for people on Medi-Cal. The Emergency Drug Benefit allows Medi-Cal to pay for drugs when a Medicare drug plan incorrectly denies coverage or when a Medicare drug plan charges more than the $1 to $5 copayment the law allows.

For you to obtain Medi-Cal coverage through the Emergency Drug Benefit, your pharmacist must submit a form to Medi-Cal showing that the Medicare drug plan is not paying for a covered drug even though the pharmacist followed all of the billing steps.

Click here for a Medi-Cal flyer (pdf) that gives more information on the Emergency Drug Benefit.

For more information on Medicare Part D, visit CANHR's fact-sheet on Medicare Part D.