WAC 182-530-7700. Reimbursement — Dual eligible clients/medicare

For clients who are dually eligible for medical assistance and medicare benefits, the following applies: (1) The agency pays medicare coinsurance, copayments, and deductibles for Part A, Part B, and medicare advantage Part C, subject to the limitations in WAC 182-502-0110 . (2) Medicare Part D: (a) Medicare is the payer for drugs included in the medicare Part D benefit. (b) The agency does not pay for Part D drugs or Part D copayments. (c) For drugs excluded from the medicare Part D benefit: (i) The agency offers the same drug benefit as a nondual eligible client has within those same classes; (ii) If the client has another third party insurer, that insurer is the primary payer; and (iii) The agency is the payer of last resort.