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Julie requested a refund within 30 days of her application filing date, she is not entitled to a refund, because she received her prescription at a discounted cost by using her SeniorCare card.

Example 2 Mike is a Level 3 SeniorCare member. Mike’s SeniorCare application filing date was October 28th and his benefit period began November 1st. On November 20th, Mike requests to withdraw from the SeniorCare program and that his $30 enrollment fee be refunded to him. Mike used his SeniorCare card on November 18th, when he purchased a prescription; however, he had not met his Level 3 spenddown, so he did not receive a discounted price for his prescription. Mike is entitled to a refund of his enrollment fee if the pharmacy reverses this prescription claim. He made the refund request within 30 days of his application filing date and he has not received any SeniorCare prescription drug benefits or services. If the claims are not reversed, Mike is not entitled to a refund. 33.3.2.2 Refunds to Deceased Members A refund may also be requested by the family member of a deceased member when all the following criteria are met: 1. They received an eligibility notification, and 2. Death occurs prior to the start of or within 30 days of the beginning of the SeniorCare benefit period, and 3. The request is made within 45 days of the date of death; and 4. They had not received any SeniorCare prescription drug benefits or services. Example 3 Henry was a SeniorCare member at Level 1 whose benefit period began December 1st. Henry passed away on December 4th. His daughter reported Henry’s death to the SeniorCare program on December 10th, and requested a refund of his $30 enrollment fee. Henry’s SeniorCare card had been used on December 1st to purchase a prescription; however, the pharmacy had reversed those charges on December 5th, since Henry’s prescription had not been picked up. The $30 enrollment fee should be refunded in this case since Henry did not receive any SeniorCare prescription drug benefits or services.

Note If all of the above conditions are met, a refund will be issued even if the death is reported beyond the refund deadline date. 33.3.2.3 Opt-In Once the opt-out of eligibility is confirmed, the member will have 30-days to contact the EM CAPO if they choose to “opt in” to the program. They would need to send another enrollment fee if the original enrollment fee has been refunded. A new application is not required to opt in. A member who decides after the 30-day period that they want to rejoin the program will need to complete a new application and submit the enrollment fee. 33.3.3 Age Limitation SeniorCare is for people who are 65 years of age or older. The earliest SeniorCare eligibility can begin is the month after an applicant’s 65th birthday. A single applicant should apply for SeniorCare no sooner than the calendar month of their 65th birthday. When a couple applies where one spouse is 65 or older and the other is under 65 at the time of application, only the spouse that is 65 or older can be determined eligible. If both apply, the younger