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Connecticut

Medicare Savings Program Offers Better Ways to Get Drug Benefits

Program picks up assistance dropped by state

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Helen Richardson, 76, of Stratford, was concerned when she had to switch from ConnPACE to the Medicare Savings Program. But the drug discount program offers better benefits and saves the state money. — Photo by Fiona Aboud

After two years as a beneficiary of ConnPACE, Connecticut's prescription drug assistance program for low- and moderate-income people, Helen Richardson got a letter telling her the program was ending. It instructed her to enroll in a Medicare Savings Program.

See also: Medicare and you: getting started.

"I was concerned," said Richardson, 76, of Stratford. She called the Southwestern Connecticut Agency on Aging and was told the Medicare Savings Program would be a satisfactory alternative.

About two years ago, in an effort to save money, the state gave ConnPACE enrollees the option of moving to the federally funded Medicare Savings Program. The program, which has three slightly different components, covers Medicare beneficiaries with monthly incomes of less than $2,260.92 for individuals and $3,052.74 for a couple. There is no asset test.

At the time, deciding whether to switch from ConnPACE to the Medicare Savings Program was voluntary, but lawmakers realized they could save money by closing ConnPACE for Medicare beneficiaries. AARP Connecticut supported the mandatory switch in July to the Medicare Savings Program because it provided greater benefits.

Better for beneficiaries

"It was better for the individual, and it saved so much money for the state," said Claudio Gualtieri, senior program specialist for AARP Connecticut.

"It didn't make sense to keep the two programs operating on parallel tracks," he said.

AARP Connecticut has encouraged current and future Medicare beneficiaries to learn whether they are eligible and enroll.

A key benefit is that the Medicare Savings Program pays for Medicare Part B premiums, representing a yearly savings of more than $1,000 to enrollees. In addition, all Medicare Savings Program participants are automatically eligible for the Medicare Part D drug program's Extra Help low-income subsidy, which assists with deductibles and copayments on prescriptions.

A major advantage of the Extra Help program is that it provides coverage when an individual falls into the "doughnut hole" — after total drug spending has reached $2,840 in 2011, and until out-of-pocket costs reach $4,550, at which point Part D provides coverage again.

During that period, the Extra Help program caps copays for prescription drugs at $6.30, a savings from the $16.25 copay previously required by ConnPACE.

'A wonderful thing'

The Medicare Savings Program "is a wonderful thing," said Nancy Krodel, deputy director for operations at Senior Resources Agency on Aging. "It really is helping people with quality-of-life issues."

The state Department of Social Services has launched an aggressive outreach effort to enroll former ConnPACE beneficiaries and make the process as seamless as possible and avoid service disruptions.

Though much downsized, ConnPACE won't disappear completely. There are still a very small number of ConnPACE recipients who are not enrolled in Medicare. Typically, these are disabled low-income adults under 65 who must wait two years after they are approved for disability benefits before receiving Medicare coverage. ConnPACE will continue to serve as their prescription drug assistance program during this period.

Just as ConnPACE beneficiaries had to reapply each year, Medicare Savings Program coverage isn't automatic; individuals must apply annually.

Medicare beneficiaries may apply to enroll in the Medicare Savings Program anytime. By law, the state has 45 days to process an application. For more information about the Medicare Savings Program, or to get an application, contact the CHOICES program through the Area Agencies on Aging at 1-800-994-9422.

Also of interest: Getting help to pay Part B premiums. >>

Jennifer Kaylin is a writer living in New Haven, Conn.

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