The Joplin Globe, Joplin, MO

Senior Outlook

Discussion

April 7, 2010

Programs assist with medicine, Medicare

Do you find yourself struggling to pay for your medications or Medicare premium assistance? There are many options available to assist you, if you fall within certain income guidelines.

Medicare Part D

Medicare Part D (also called the “Medicare Prescription Drug Program”) is an optional program that helps pay for prescription drugs. A variety of plans are offered through private companies that have been approved by Medicare.

The benefits of Medicare Part D include prescription drug coverage for everyone with Medicare regardless of income and resources, health status or current prescription expenses; both brand name and generic prescription drugs at participating pharmacies that are convenient to the individual; and protection for people who have very high drug costs or from unexpected prescription drug bills.

Low income subsidy

Also called “Part D Extra Help,” this is an assistance program that has higher income and asset limits than Medicaid. The Extra Help offers assistance to beneficiaries by helping them only pay medication expenses through the Medicare Part D program. A beneficiary can be enrolled in a stand-alone prescription drug program or a Medicare Advantage drug plan. Enrollment for this program is done through the Social Security Administration.

For individuals, the income limit is $16,245 per year and $21,855 for couples. Your resources must be below $12,510 (for individuals) or $25,010 (for couples).

QMB/SLMB/QI-1

The Qualified Medicare Beneficiary Program (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualified Individual-1 (QI-1) programs are for people who are enrolled in Medicare whose income and resources are within the program guidelines. These programs can provide assistance in paying for premiums, deductibles and coinsurance. In order for you to be eligible for one of these programs, you must have a gross monthly income of no more than $1219 per month (or $1640 per couple.

Missouri Rx

Missouri Rx Plan (MoRx) works with Medicare Part D to help individuals save money on prescription drugs. It does this by covering 50 percent of an enrolled person’s out of pocket costs, including any deductibles, co-payments, and costs during the gap in coverage and beyond.

To qualify for MoRx you must be a Missouri resident and enrolled in a Medicare prescription drug plan or Medicare Advantage Drug Plan. If you’re single, your annual gross income must be $21,660 or less, and $29,140 if married. There are no resource limits with this program.

As with all assistance programs, there may be additional limitations not listed here. If you have questions about any of these programs and think you may qualify, please call the Area Agency on Aging office at (417) 781-7562.

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