Winter 2015
  Aging Issues


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Prescription Drugs

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Acquiring prescription drugs at an affordable price is a challenge for many senior adults. The following programs may be of assistance to individuals who qualify.

Medicare Part D

Medicare Part D provides prescription drug coverage through private insurance plans. Some basics for Medicare Part D:

  • The benefit is available to any Medicare beneficiary who has Medicare Part A or Part B or both.
  • There is a monthly premium, an annual deductible & co-payments for each prescription. The costs depend on which Plan you choose
  • Enrollment in Part D is optional. But if you do not sign up when you are first eligible and change your mind later on, you may have to pay a penalty or higher premium. There are some exceptions to the penalty.
  • Explanation of the Part D Penalty
  • The Annual Enrollment Period is from October 15 to December 7th. Exceptions: If you are first eligible for Medicare, you can enroll in a Medicare Prescription Drug Plan within the 7-month Initial Enrollment Period. Also, you can enroll in a Medicare Prescription Drug Plan when you first become eligible for low income subsidy (Extra Help). For more details and to apply click “Extra Help“.
  • For a  Guide on choosing the Plan that is right for you and a list of Medicare Drug plans offered in the state of Connecticut click on: Guide to Choosing a Medicare Prescription Drug Plan 2017.

Extra Help with your Prescription Costs

Some Medicare beneficiaries are eligible for Extra Help to pay for the costs, including the monthly premium of a Part D prescription plan, annual deductible and prescription co-pays.  To qualify for the Extra Help the person must be on Medicare and have limited income and resources.  To see if you qualify for Extra Help click here.

For more information on Medicare Prescription Drug coverage, call CHOICES at 1-800-994-9422 or click on Medicare. The Plan Finder in the Medicare website is a particularly helpful tool to compare the different Medicare Prescription Drug Plans and to identify a Drug Plan that is appropriate for your own situation.

 

MEDICAID

Prescription drug coverage under Medicaid (Title 19) is now under Medicare Part D. If you have both Medicare & Medicaid (Dual Eligible), you must enroll into a Medicare Prescription Drug Plan to get your prescription coverage. If you are a “dual eligible”, you may not have to pay a monthly premium, if you enroll in a CT benchmark plans.  For a list of CT Benchmark Plans click here.

New changes to Medicaid:  The state will no longer pay for drugs that are not on the formulary of the Part D drug plan.  Medicaid will only continue to cover the cost of those drugs “excluded” from Part D coverage such as benzodiazepines and barbiturates.

The changes will not affect those Medicaid beneficiaries who do not have Medicare.

Contact the CHOICES program at 1-800-994-9422 for more information, or go to the following link for more details: Medicaid facts brochure

PATIENT ASSISTANCE DRUG PROGRAMS

These are special programs by drug companies to help people who cannot afford the cost of their brand name prescription drugs. These companies have programs to give people prescription medicine free-of-charge or for a very low cost to individuals in need, regardless of age if you meet the criteria. If it is hard for you to pay for your drugs, ask your doctor if he or she can help you get assistance from the drug companies. These are not public benefit programs. Acceptance is entirely up to the drug company. These programs do not cover generic drugs.

Who is Eligible? 

  • Your have no insurance that covers outpatient prescription drugs
  • You do not qualify for a government assistance program for prescription drugs (like Medicaid)
  • Your income must be within certain income limits
  • If you have Medicare Part D, or if you are eligible but decide not to enroll in Part D, you may or may not be eligible, depending on the specific program.

For more information and the application process, click on NeedyMeds.

The HOPE Dispensary of Greater Bridgeport is a charitable pharmacy dedicated to serving low-income and uninsured individuals in the Bridgeport community.  Qualified patients are enrolled into the Pharmaceutical Manufacturer Assistance Programs (PAPs) as well as fill prescriptions for a shot term supply from their limited inventory.

In addition, Benefits Check Up, offers a screening opportunity for a wide variety of national prescription drug discount programs. The screening can be accomplished on your computer and is free.

VETERANS BENEFITS

Outpatient pharmacy services are provided  to qualifying veterans who meet eligibility requirements and veterans receiving medications for treatment of service- connected conditions.

To receive benefits, a veteran must fill out an application to enroll in the VA health care system. An application may be obtained by calling 1-877-222-8387. The individual must see a doctor at the VA before the prescription will be filled.

For general information about VA pharmacy services, contact the VA at 1-800-827-1000.

Other contact points are the VA in Newington (860-666-6951) or West Haven (203-932-5711). Ask for the Eligibility Department.

Please note: There are military retiree benefits under the TRICARE program. Ask the VA eligibility department about those benefits. Active duty or military retirees may be eligible for benefits under TRICARE.