Medicare's Pharmacy Hotline is toll free 1-866-835-7595
Call (573) 751-6963
Use the following BIN/PCN when submitting claims to MoRx: 004047/P021011511
Use the following BIN/PCN when submitting excluded drug claims: 004047/P021011511
No, the MoRx BIN/PCN is to be used for all payments for dual eligibles. MO HealthNet's BIN/PCN is to be used for MO HealthNet only participants.
004047/43-1754897
A group ID number is not required. Plan information BIN/PCN and Participant ID are the only information needed to process a claim.
The member's Medicare Beneficiary ID number will be their MoRx ID number. The Medicare Beneficiary ID number is identified on their Medicare card as their "Medicare Claim Number". This number is also commonly referred to as the HICN.
MoRx pays toward the out of pocket cost of the formulary of the Medicare Prescription Drug Plan (PDP). Any prescription drug covered by a member's Medicare PDP will also be covered by MoRx. For dual eligible members, Part D excluded drugs will continue to be covered.
No, but the PDP information will be available to the pharmacies through an E-1 transaction.
All dual eligibles are automatically enrolled in MoRx. Enrollment is currently open for other income eligible Medicare beneficiaries. Learn more about enrolling in MoRx.
No. MoRx does not work with mail order pharmacies. MoRx will provide wrap-around benefits for covered prescriptions purchased at any non-mail order pharmacy that is contracted with MO HealthNet and with the member's Part D plan.
MoRx only accepts claims that are submitted electronically and cannot accept paper claims submissions.
No. The MoRx benefit will not cover a 90-day supply (3 months) of medication. The MoRx benefit will cover up to a 31-day supply of each prescription at a time.
No. All LTC pharmacies in a region need to negotiate terms and conditions with as many plans as possible or risk losing business to another more competitive LTC pharmacy. PDPs are encouraged to work with all LTC pharmacies so that all of the PDP's enrollees can get prescriptions.
Blind Pension participants (ME Code 02) do not have to enroll in a Part D plan. MO HealthNet will continue paying for their prescription drugs. Other ME codes that are likewise exempt from the Part D requirement are 08, 09, 57, 59, 64 and 65.
Medicare Part D co-pays are real co-pays. Unlike MO HealthNet co-pays, providers may refuse service if a patient does not pay their Medicare Part D co-pay.
08/30/07
