PRESCRIPTION ADVANTAGE
*** OPEN ENROLLMENT OPEN ENROLLMENT ***
SEPTEMBER 1 THROUGH SEPTEMBER 30, 2004
The Executive Office of Elder Affairs (EOEA), which administers the Prescription Advantage drug insurance plan, has announced an Open Enrollment period from September 1 through September 30, 2004. This is the first Open Enrollment period since August of 2003. Individuals age 66 and older can only enroll during an open enrollment period, with very limited exceptions. Apply on time! EOEA must receive completed applications by September 30, 2004. Coverage for eligible applicants will begin November 1. New application forms will be available mid July at Councils on Aging, from SHINE counselors, at www.800ageinfo.com, or by calling 1-800-243-4636.
What is Prescription Advantage?
Prescription Advantage is a prescription drug insurance plan available to all Massachusetts residents age 65 and older, as well as to younger persons with disabilities who meet specific financial and employment criteria. Members pay premiums, deductibles, and co-payment amounts (up to an annual out of pocket limit), based on gross annual income. Prescription Advantage offer members most oral outpatient drugs (generics at the lowest co-payment, then progressively higher co-payments for brand name drugs), insulin, and disposable syringes with needles.
Who is Eligible for Prescription Advantage?
Persons who have no MassHealth medication coverage and (1) are 65 years of age or older; OR (2) are under 65, are disabled, who work no more than 40 hours a month, and have income of not more than 188% of the federal poverty level (in 2004, $1,408 for one; $1,872 for a couple).
Having a Medicare endorsed or other drug discount card does NOT disqualify an individual from Prescription Advantage. In fact, Prescription Advantage encourages those who qualify for the $600 low income assistance offered by the Medicare approved cards to apply for one of those cards.
Why is Open Enrollment so Important?
People who are 66 or older can only enroll during an open enrollment period except for narrow exceptions. There may not be another open enrollment period for a long time if the program is found to be under financial constraints. The last Open Enrollment was August 2003. Remember: for the September, 2004, open enrollment period, applications must be received no later that September 30, 2004. If approved, applicants will begin coverage on November 1, 2004.
HAVE QUESTIONS OR CONCERNS?
CALL THE MEDICARE ADVOCACY PROJECT (MAP)
1-800-232-3205