Notice of Termination of Illinois Cares Rx Benefit

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Dear Illinois Cares Rx Member:

We regret to inform you that the Illinois Cares Rx program is ending June 30, 2012. Due to Illinois state budget reductions, funding for the program is being eliminated. This means beginning July 1, 2012, Illinois Cares Rx will no longer help you pay for your prescription drugs and Medicare Part D plan. It is important that you contact your Medicare Part D prescription drug plan to find out what your premium and prescription drug costs will be beginning July 1, 2012. See Illinois Cares Rx Coordination Plans for phone numbers for the Part D plans that were coordinating with Illinois Cares Rx.

If you are enrolled in a Medicare Part D plan, you will continue to receive prescription drug coverage through that plan. You will not be dropped from your Part D plan because the Illinois Cares Rx program is ending. 

Beginning July 1, 2012, if your Part D plan has a monthly premium, you will have to pay it.  If you don’t pay your premium, you may lose your Part D Coverage. Contact your plan to find out how much your premium will be and how you will pay it. In most cases, your Part D plan will send you a booklet of premium payment coupons to send in with your checks. However, some plans don’t have premiums or your premium may be automatically deducted from your bank account or social security check. 

Also beginning July 1, the amount you pay at the pharmacy for each prescription you fill may change. In addition, you will have to pay any remaining deductible (if your Medicare Part D plan has a deductible).

However, if you have Low Income Subsidy (LIS) assistance from the federal government (also known as Extra Help) the amounts that you will pay for each prescription you fill may remain the same. If you do not currently have LIS, you can see if you qualify and complete an application by visiting the Official Web site of the U.S. Social Security Administration or by calling 1-800-772-1213 (TTY 1-800-325-0778). 

You can choose a different Medicare Part D plan. Since you no longer have Illinois Cares Rx, you can switch to a different Medicare drug plan for the rest of 2012 if you wish. You may choose either a stand-alone Medicare Part D plan or a Medicare Advantage plan with costs and coverage that better meet your needs. If you decide to change plans, you must enroll in the new plan between June 1, 2012 and August 31, 2012.

For assistance comparing drug plan options in your area or enrolling in a different plan, contact one of the SHAP Outreach Sites (pdf). If you are in a Medicare Advantage plan that also covers your doctor and hospital care, you may wish to contact the Senior Health Insurance Program (SHIP) at 1-800-548-9034. Or you may visit the Medicare Web site or call 1-800-MEDICARE (1-800-633-4227); TTY/TDD users should call 1-877-486-2048.

Even if you choose to change your plan now, you will still have another chance to change plans for 2013 along with everyone else during the Part D annual enrollment period (October 15-December 7, 2012).

Section 2.  If You Do Not Have Medicare, the following information applies to you.

You will no longer receive prescription drug coverage through Illinois Cares Rx. Beginning July 1, 2012, you will be responsible for paying the full costs for your medicines.

However, if you have discount programs, private health insurance, or get help through the V.A. that pays your prescription drugs, that coverage will not change.

Section 3.  If you have Medicaid, the following information applies to you. 

If you have Medicaid and are enrolled in a Medicare Part D plan, you will continue to receive prescription drug coverage through that plan and Medicaid will continue to provide assistance paying for the cost of your Medicare Part D excluded drugs. You will also continue to pay the same co-payment for your prescription drugs through your Part D plan because you are automatically qualified for the LIS assistance from the federal government.

If you have Medicaid and no Medicare, you will continue to receive your prescription drug coverage through Medicaid.

Section 4.  Assistance for Individuals with HIV or AIDS

If you have HIV or AIDS, a program offered by the Illinois Department of Public Health that assists with prescription medicines and health insurance premiums may be able to assist you. For help paying for your prescription drugs, the AIDS Drug Assistance Program (ADAP) offers 80 FDA approved drugs for the primary treatment of HIV and AIDS. The ADAP application is available on the Illinois Department of Public Health Web site and on the HIV Care Connect Web site. Questions and concerns can be directed to the ADAP office at 1-800-825-3518.

Section 5.  Help is Available

• For questions about your Illinois Cares Rx drug coverage, contact the Health Benefits Hotline at 1-800-226-0768 (TTY 877-204-1012); Senior HelpLine at 1-800-252-8966 (TTY 888-206-1327); or

• For Medicare counseling, contact the Senior Health Insurance Program (SHIP) at 1-800-548-9034 (TTY 217-524-4872); or

• For assistance comparing Medicare Part D plans, contact one of the local agencies listed on page 3; or

• You may qualify for assistance from a private discount program. Following are links to two Web sites that might be helpful:
  • Rx Assist Patient Assistance Program Center
  • Rx Outreach

• Visit the following Web sites for additional information:
  • Circuit Breaker and Illinois Cares Rx