A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

41,000+ Seniors and Disabled To Lose Prescription Assistance

41,000+ Seniors and Disabled To Lose Prescription Assistance

December 1, 2009

Budget cuts are eliminating benefits for over 41,300 low income people in Prescription Advantage, which helps seniors and some younger persons with disabilities afford their medications. After a series of budget cuts, starting Januaury 1 the program will only provide a fraction of the assistance it provided just a year ago.

Prescription Advantage will no longer provide premium assistance for Medicare Part D monthly premiums for any Prescription Advantage members. For individuals with less than $16,245 in annual income, Prescription Advantage still provides immediate co-payment assistance (on a sliding scale). For individuals with annual income between $16,245 and $32,490, Prescription Advantage only provides co-payment assistance once a member enters the Medicare Part D Donut Hole ($2,830 in drug costs). For members who have an annual income between $32,491 and $54,150, they must first pay an annual fee of $200 and then Prescription Advantage will provide co-payment assistance once that member has incurred out-of-pocket costs of $3,250.

Because of these significant changes in the program, Medicare members may want to change the Medicare Part D plan in which they are enrolled for a cheaper plan. Part D open enrollment lasts until Dec. 31st. Members can get plan selection advice from their local SHINE office or by calling: 1-800-AGE-INFO.

For more detail on the changes to the Prescription Advantage Program, please see the new Prescription Advantage Benefit Chart.
- Georgia Maheras