Dear Pharmacies in Christian, Logan, Macon, Menard, Piatt, and Sangamon counties:

You should have received information from the Illinois Department of Healthcare and Family Services (HFS) on the transitions occurring for the Medicare-Medicaid Alignment Initiative (MMAI) beneficiaries in the following six counties: Christian, Logan, Macon, Menard, Piatt, and Sangamon. MMAI members of Molina Health Plan were moved to a SilverScript Medicare Part D prescription drug plan (also known as a "Part D plan") unless they chose another Part D prescription drug plan. Impacted beneficiaries have received notices from Molina telling them about this change.

If former Molina members in these counties attempt to use their Molina insurance card at your pharmacy on or after May 1, 2017, the claim will be rejected. These beneficiaries are now enrolled in a SilverScript insurance company Part D plan, or another Part D plan coverage. These beneficiaries will also be in Medicaid fee-for-service and use their Healthcare and Family Services (HFS) medical card to access any prescription drugs that are not covered by Medicare but are covered by Medicaid. Please verify coverage and send the claim accordingly. Note: Pharmacist should do an E1 query to get the billing codes for the new plan. In the event that the E1 query shows no plan, Pharmacist can bill LINET.

Note: There will be no change to beneficiary insurance coverage, unless they elect to make a change, for MMAI Molina members in Central Illinois in the following counties: Champaign, Ford, Knox, McLean, Peoria, Stark, Tazewell, and Vermillion. MMAI members in Chicago (Cook County) and surrounding counties (DuPage, Lake, Kane, Kankakee, and Will) are also not be impacted by the changes in coverage and program options.

Thank you.