Further Reducing Your Medication Costs
If you have gross annual income at or below $16,335/individual or $22,065/couple, and cash assets at or below $12,640/individual and $25,260/couple you may be eligible for help from Social Security with the costs of a Medicare-approved prescription drug plan (income amounts may be higher if beneficiaries financially support a relative other than a spouse who lives with them). You can apply for the Low-Income Subsidy (LIS) online at the Social Security Administration Web site or by calling Social Security (1-800-772-1213) or the NC Seniors’ Health Insurance Information Program (1-800-443-9354). In Durham, you may also call Senior PharmAssist (919-688-4772). If you think you may qualify, IT PAYS TO ACT IMMEDIATELY. If you do not qualify for the maximum amount of LIS assistance, you may be eligible for other help with your out-of-pocket medication expenses.
Until this summer, North Carolina had offered Part D premium assistance of up to $29/month to seniors 65 and older with limited incomes who did not qualify for full LIS and met other criteria. This benefit had been paid for by the NC Health and Wellness Trust Fund. Despite the efforts of Senior PharmAssist and other advocates across the state, this funding source was eliminated mid-year, leaving many seniors scrambling to afford their Part D coverage. In Durham, Senior PharmAssist helped participants review their options and switch to lower-cost plans if appropriate. Fortunately, these individuals qualify for our program's supplemental prescription coverage.
Participants in our supplemental program use their Medicare card first and then our card as a back up. For medicines on our geriatric formulary (safer, more effective and more cost-effective medications for older adults), our participants pay no more than $2 for generics or $5 for brand-name medications. In other words, Senior PharmAssist picks up the cost of covered medications whenever the Medicare plan does not — before, during and after the “doughnut hole” or coverage gap. And THERE IS NO DEADLINE TO ENROLL in Senior PharmAssist’s supplemental program. Our participants also receive hands-on assistance to help them better manage their medicines and access other community resources, which can further enhance their well-being.