State Pharmaceutical Assistance Program: Pennsylvania

There are millions of Medicare beneficiaries that needs assistance paying for their medications each month. The cost of living has increased and many of the residents that need assistance paying for their medications are seeing their savings get lower. Many of these residents have begun having to make difficult choices; some beneficiaries have to choose between paying their bills, eating or getting all the medications they have been prescribed. Although many of these Medicare beneficiaries have Medicare part D, they still struggle under the amount of money they have to pay.

Most states know their Medicare beneficiaries are having to make difficult choices regarding their medications and maintaining their standard of living. Some states have put programs in place to help these beneficiaries pay for their medications. The programs that have been put in place are called stat pharmaceutical assistance programs. These programs are normally only available for those that live in the state that is sponsoring the program. It’s not an open program for applicants across the country.

Pennsylvania is one of those states that offer state pharmaceutical assistance programs.

Pharmaceutical Assistance Contract for the Elderly (PACE)

Pennsylvania created the Pharmaceutical Assistance Contract for the Elderly to help those in need. This is a program that is only for residents in Pennsylvania. Residents of the state that are interested in enrolling into the program should call 800-225-7223 or 717-651-3600. Those that are not residents of the state shouldn’t apply.

Eligibility Requirements

Those that are interested in applying to the program should know the following eligibility requirements must be met:

Must be a Pennsylvania resident for at least 3 months before submitting an application

Must be 65 or over

Must not be enrolled in the Department of Public Welfare’s Medicaid prescription benefit

Can’t be eligible for assistance under medical assistance

Income for the year before application can’t be more than $14,500 for a single person or $17,700 for a married couple

Who to Contact

Those that have questions on the program or want to apply should contact:

PACE/PACENET

Po Box 8806

Harrisburg, Pa. 17105

What are the Benefits?

People that apply and are accepted into this program can enjoy the following benefits:

$6 copayment on generic medications for a 30 day supply

$9 copayment on name brand medication for a 30 day supply

*Although PACE coverage is considered credible coverage, those with Medicare Part D prescription drug plans can still apply and qualify

Pennsylvania PACE Needs Enhancement Tier (PACENET)

Pennsylvania has another SPAP program their residents can apply for and receive. Those that have been a resident of Pennsylvania and are interested in the program can call 1-800-225-7223 or 717-651-3600 for more information.

Eligibility Requirements

Those that are interested in the program must meet the following requirements:

·         Must be a resident of Pennsylvania (must be a resident of the state for at least 90 days prior to submitting application)

·         65 or older

·         Income for a single person must not be more than $23,500 (the previous year’s income is considered)

·         Income for a married couple can’t exceed $31,500 (the previous year’s income is considered)

·         Can NOT be enrolled in the Dept. of Welfare’s Medicaid prescription benefit

Who to Contact

Those that feel they qualify should contact:

PACENET Program

P.O. Box 8806

Harrisburg, Pa. 17105

What are the Benefits

Those that qualify, apply and are approved for the program can look forward to the following benefits:

·         $8 copay for a 30 day supply of generic medications

·         $15 copay for a 30 day supply of name brand medications

PACENET beneficiaries that are not enrolled with in a Medicare Part D prescription drug plan will pay $35.50 as a premium to their pharmacy each month.

Pennsylvania offers 2 state pharmaceutical assistance programs. For those that apply and don’t qualify for either, help still may be available. Those that apply and are denied, the Social Security Administration has a Low Income Subsidy Program available for some and many do qualify.

Feb. 28 14'
I would like to get the Medicare booklet. But you don't make it easy to just get the book wotihut asking for a quote. I'm on Medicare and have Part B and Part D but Im not happy with the Part D perscription plan that they put me on. I'd like to see what is available to me.
May. 25 14'

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