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Prescription Drug Assistance Programs is a Medicare program that assists in the prescription of drugs for beneficiaries. It was implemented when the authorized passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

The said program primarily assists Medicare beneficiaries in the payment of outpatient prescription drugs purchased at mail orders, home infusion, retail, and long-term care pharmacies. It is open to all beneficiaries of the Medicare program. However, the Medicare Part D Prescription Drug Plans are not free and the coverage plans need to be paid.

As we all know, having access to drugs can support and help individuals to be medically stable. Furthermore, it is one of the factors in recovery from illnesses and diseases. Based on one of the reports of the National Center for Health Statistics, almost 14 percent of the poorest adults whose income is below the poverty level skip mediations just to save money.

Also, another 14% of the community had no insurance, and 6% of its benefit was from private insurance. Furthermore, 10% of Medicaid recipients skipped mediation just to lessen the cost of the program. And this is where the problem lies, there are millions of individuals who are still not capable of buying their drug prescription for their respective mediation.

That’s why Medicare Part D Prescription Drug Plans were created, to assist more individuals to have access to drug prescriptions. Prescription Drug Assistance Program was divided into several plans where individuals can apply to cover their respective drug prescriptions.

These plans have a wide variety of benefits that focus on helping beneficiaries with the payment of their drug prescriptions. Medicaid beneficiaries can freely choose from the plans of Medicaid Part D as long as they can pay for its cost.

What do the Prescription Drug Assistance Program Plans Cover?

Prescription Drug Assistance Program Plans cover a wide variety of drug prescriptions for their beneficiaries. The drugs that are covered by the said program were defined by the Medicare law. However, the drugs covered by the Medicare Part D plans will vary depending on the plan of an individual. All Prescription Drug Assistance Program Plans have their respective formulary.

It is the list of covered prescription drugs of health insurance. Moreover, it also has tiers, it is the categorization of mediation covered by the plans. Usually, each formulary has three to five tiers that are different from one another. So, individuals must always check the formulary and tiers of the plans before enrolling to find the best plan for them.

What are the Best Plans?

As there are a wide variety of Medicare Part D plans, there are also some plans that are highly recommended by the beneficiaries. It means that these plans were useful and reliable to support the access to drug prescriptions of each individual.

However, individuals can still freely choose the plan that they want but below are the suggestions for the best Prescription Drug Assistance Program Plans.

  • Kaiser Permanente
  • UnitedHealthcare (AARP)
  • BlueCross BlueShield (Anthem)
  • Humana
  • CVS Health (Aetna and Silverscript)
  • Cigna (Express Scripts)
  • Centene (WellCare)

How to have Prescription Drug Assistance Program Plans?

To access Medicare drug coverage, individuals must join a Medicare-approved plan which offers drug coverage. The cost of these plans will vary depending on the type the Medicare plan. See the possible ways below on how to get Medicare drug coverage.

Medicare Drug Plans

Medicare drug plans will add Medicare drug coverage to the original programs of Medicare, Medical Savings Account Plans, Medicare Cost Plans, or with some Private Fee‑for‑Service plans. To join a separate Medicare drug plan, individuals must have access to Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance).

Medicare Advantage Plan Or Medicare Health Plan

Offers drug coverage Within Medicare Advantage Plan or Medicare Health Plan, individuals will have Part A and Part B as well as the drug coverage program of Medicare. Visit the Medicare official website to find the specific cost of the Medicare Advantage Plan and Medicare Health Plan.

Once an individual was already enrolled in a Medicare drug plan, he/she will receive a Medicare card that indicates the Medicare Number and the start date of Part A and Part B coverage.

What is Extra Help?

Extra Help is a program offered by the State’s Social Security Administration to help individuals to access the Prescription Drug Assistance Programs of Medicare. It was created to assist and support low-income individuals who cannot afford the cost of Medicare Part D Prescription Drug Plans.

The said program can help its beneficiaries with the cost of Medicare Part D such as monthly premiums, copayment, and annual deductible. With Extra Help, low-income individuals can still get Prescription Drug Assistance Programs.

Qualification for Extra Help

To qualify for Extra Help, the annual income for single individuals must not exceed $18,090 while $24,360 for married individuals. Moreover, the maximum amount for combined savings, real estate, and investments of single individuals must be $13,820 and $27,600 for married individuals.

If individuals meet the following requirements, they can be automatically eligible for Extra Help.

  1. Have full overage of Medicaid.
  2. Have help from the state Medicaid program for the payment of Medicaid Part B premiums.
  3. Have Supplemental Security Income (SSI) benefit)

In addition, not all local state of the United States offers Extra Help. Refer to the list below for the states who offer Extra Help.

  • Vermont
  • Wisconsin
  • Delaware
  • New Mexico
  • Indiana
  • Massachusetts
  • Maryland
  • New York
  • Pennsylvania
  • Rhode Island
  • Maine
  • Missouri
  • Montana
  • Nevada
  • New Jersey
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