The Med Diva

An insider's guide to Medicare Part D and more

Archive for the category “State Pharmaceutical Assistance Program”

Countdown to Medicare Part D Open Enrollment: Day 8

Open Enrollment for 2012 begins on Saturday, October 15, and ends on Wednesday, December 7, 2011.

Day 8: Getting Extra Help with your prescription drug costs

 In a recent poll conducted for the National Council on Aging (NCOA), more than half of the Medicare beneficiaries surveyed (53 percent) said they were not aware of Extra Help from Medicare, which helps pay for some or all prescription drug costs for those with low incomes. If you or a loved one that you care for takes medication on a regular basis and has a limited income and investments, it’s important to be aware of this benefit.

To qualify for Extra Help, you must:

  • Have Medicare Part A (hospital insurance) and/or Medicare
    Part B (medical insurance); and
  • Live in one of the 50 states or Washington DC; and
  • Have combined savings, investments, and investment real estate worth no more than $25,260 (if you are married and living with your spouse) or $12,640 (if you are not currently married or not living with your spouse.)

When considering your total worth, do not include the home you live in, your cars or other vehicles, personal possessions, burial plots, or back payments from Social Security or Supplemental Security Income (SSI). Also, if you have Medicare and SSI or you have Medicare and Medicaid, you are automatically getting Extra Help for your prescription drugs so you do not have to do anything else.

 For more information about Extra Help, click here, contact your local Social Security office, or call Social Security at 1-800-772-1213. (TTY: 1-800-325-0778).  You will need to complete and submit an application, which will be reviewed by Social Security to determine if you qualify. Social Security will notify by letter if you qualify or not.

State Pharmaceutical Assistance Programs (SPAPs)

Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other prescription drug costs. Each state has its own set of eligibility requirements; for example, in New York your income must not be more than $50,000 if married, while in New Jersey a married couple cannot have an income higher than $39, 956. Click here to find out if your state has a SPAP.

In tomorrow’s countdown, I’ll review the Coverage Gap Discount Program, which was enacted under health care reform legislation and is already helping thousands of seniors substantially lower their drug costs.


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