Back in September, we shared an exciting stretch goal: raise $47,000 in new, lapsed, and increased gifts (compared to last year) by February 14 as part of the Fox Family Foundation/SPA Board of Directors Challenge Grant.

Thanks to your incredible generosity, we didn’t just meet that goal — we shattered it, raising an amazing $91,068 from new donors ($7k), folks re-engaging after not contributing last year ($41k), and stunning increased giving ($43k).

What does this mean? Senior PharmAssist will continue to “answer the call” when people ask for help navigating their prescription needs in Durham – including how to best leverage Medicare health and drug coverage and tap into other programs that improve the quality of life for older adults with fixed and limited incomes. What a gift! We remain “short” on several other annual fundraising goals for FY26 so this display of generosity is a much-needed boost at this time. 

When EM, a 71-year-old, received news that her endometrial cancer had returned, she was already facing an uphill battle. Soon after, she developed a deep vein thrombosis (DVT) in her leg and was prescribed Eliquis (apixaban), a critical blood thinner to prevent another clot. However the cost of the medication felt overwhelming. Though her income made her ineligible for Medicare’s “Extra Help,” she qualified for assistance through Senior PharmAssist—and her doctor’s office encouraged her to call us.

Mrs. M reached out one morning with urgency in her voice. She had only two doses of her blood thinner left, and winter weather was forecasted to hit Durham within days. Without the medication, she risked serious complications. Fortunately, there was an appointment available that very afternoon and we were able to arrange a ride so she could get to the office safely and on time.

During her visit, one of our pharmacists conducted a comprehensive medication review and worked directly with her pharmacy to ensure her Eliquis could be processed using Senior PharmAssist’s prescription benefit card. She paid $20 for a 30-day supply of her medicine. Fortunately, Eliquis is one of the medicines that has a negotiated price with Medicare so Senior PharmAssist’s share of the cost has been cut in half! (The list price, nearly $600 last year, decreased to $250 in 2026 thanks to the Inflation Reduction Act of 2022.) Mrs. M was able to pick up the medicine before the winter storm arrived—avoiding both a dangerous lapse in treatment and the added stress of navigating icy roads.

But the support did not stop there.

During her appointment, we learned that Mrs. M was also struggling to address other basic needs. She was referred to community resources for home repairs, including HVAC and flooring issues, and connected with food support through the Durham Center for Senior Life’s commodity box and pantry programs.

What began as a call about one medication became a coordinated response to stabilize her health and home. Life is hard enough and when we have the opportunity to accompany our participants as part of their care team, it is an honor and privilege.

Your financial support and many agency collaborations make this possible. Thank You!

We're looking for new SHIIP volunteers to provide Medicare counseling!

A Medicare Moment: To B or Not to B – That is the Question

When should someone enroll in Medicare Part B?

As a surprise to many – if you reach 65 and have not started Social Security benefits, Medicare will not automatically begin for you. You have critical decisions to make and if you are still working - should always talk to your employer’s HR department to learn their guidelines.

Part B is not covered by payroll taxes (like Part A). It is covered by enrollee premiums (25% on average) and is heavily subsidized by general revenues of the federal government. Part B covers provider services and most outpatient services at 80% of the “allowable” (what Medicare allows providers to be paid).

If you are actively working (not on COBRA, for example) for a large employer you will like benefit from delaying enrollment in Medicare Part B until you retire or are not actively working. This includes if you are dependent on your working spouse’s insurance.

Large employer by Medicare standards: 20+ employees if enrolled in Medicare due to age and 100+ employees if enrolled in Medicare due to a disability.

It also depends on how much you or your spouse pays for employer coverage and how the benefits stack up to Medicare. If your health and drug insurance is costing you more than $350/person – you will want to look at Medicare enrollment options. If paying less than $350/person – it may be best to delay Part B enrollment for two reasons.

1. Paying Part B premiums is not cheap – it is currently $202.90/month for most people. If your annual income is above $109k/single or $218k/couple then you will pay “IRMAA” (Income-Related Medicare Adjustment Amount), which means higher premiums for both Medicare Part B and D (drug benefit).
2. As important, if you start Part B while still working for a large employer – you are not only wasting your money (as your employer coverage is paying the bills) but the 6-month “guarantee issues right” clock to a Medigap supplement policy starts ticking once Part B begins. You would have insurance “underwriting” in North Carolina after that six months when you do retire; this is when insurance companies can charge you significantly more for a Medigap policy or deny you coverage all together due to your health status.

If you are working for a small employer or are no longer actively working, or retired; you likely need to enroll in Medicare Part B (and Part A if you haven’t already) as Medicare becomes the primary payer (pays first). If you do not start Part B on time in this instance, you may have lifetime late enrollment penalties.

See our “Medicare Misunderstandings and Musings” for other related topics.

It should not be this confusing and we are working to standardize and simplify the “choice architecture.” Fear not – attend one of our Medicare educational sessions or make an appointment for counseling at Senior PharmAssist at no charge.

And remember - know your meds, know your coverage, know your rights.

Donate today!

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