PRESCRIPTION DRUGS        

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

A Medicare benefit that  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.
  • The Annual Enrollment Period is from November 15 to December 31. 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 link below:
    CT Prescription Drug Plans 2010.

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.

ConnPACE      

ConnPACE helps seniors and people with disabilities pay for certain prescription drugs, insulin and insulin syringes. There is an annual enrollment fee of $45 and a co-payment of up to $16.25 for each prescription.  (Click on image to connect to ConnPACE website)

2010 Eligibility Guidelines 

  • Must live in CT for at least 6 months immediately before applying.
  • Must be at least 65 years old, or disabled and receiving Social Security Disability or Supplemental Security Income. If disabled, person must be over 18 years of age.
  • Adjusted gross income for the previous year plus Social Security benefits (minus Medicare Part B premiums) must be less than $25,100 for a single person and $33,800 for a married couple. Sources of income include Social Security, Supplemental Security and Railroad Retirement income, pensions, wages, interest, dividends, net rental income, veterans’ benefits and other non-taxable income.
  • If you have other insurance that covers prescription drugs, you may or may not be eligible. Call CHOICES at 1-800-994-9422 for details.
  •  You have to enroll in a Medicare Prescription Drug Plan if you are eligible for Medicare, and you have to show proof that you have applied for Extra Help.

Applying for ConnPACE 

  • Enrollment for ConnPACE corresponds to the Medicare Part D Open Enrollment Period which runs from November 15th through December 31st of every year.
  • Those turning 65 or newly deemed disabled have a special enrollment opportunity that begins the day they turn 65 or are deemed disabled and goes for 30 days.
  • To acquire a ConnPACE application  call ConnPACE at 1-800-423-5026 or  CHOICES at your local Area Agency on Aging  1-800-994-9422. You can also download an application on-line by going to the following link:ConnPACE application
  • Questions regarding the application and the documents that need to be submitted can be answered by calling 1-800-423-5026 between 8:30 am and 4:30 pm. 
  • If the application is complete and a person is eligible, the individual will receive a ConnPACE card in about 45 days. The card is good for one year. If the person is not eligible, an explanation will be sent along with the fee refunded. If the application is not complete, a letter will be sent requesting the missing information.

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 p 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.

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.