I have Medicare and benefits through Programs of All-inclusive Care for the Elderly (PACE)
PACE combines medical, social, and long-term care services for frail people who live and get health care in the community. These programs are a joint Medicare and Medicaid option in some states.
You don’t need to join a separate Medicare drug plan because you get Medicare prescription drug coverage through PACE.
Caution: If you join a Medicare drug plan, you will be disenrolled from your PACE plan. Your PACE plan provides not only your prescription drug coverage, but all of your heath care services. Therefore, if you disenroll from your PACE plan by joining a Medicare drug plan, you will no longer receive other health care benefits from your PACE plan. Contact your PACE plan for more information.
If you also have full Medicaid coverage, you get prescription drugs at no cost to you through your PACE plan.
Caution: If you join a Medicare drug plan, you will be disenrolled from your PACE plan. Your PACE plan provides not only your prescription drug coverage, but all of your heath care services. Therefore, if you disenroll from your PACE plan by joining a Medicare drug plan, you will no longer receive other health care benefits from your PACE plan. Contact your PACE plan for more information.
If you also have full Medicaid coverage, you get prescription drugs at no cost to you through your PACE plan.
If you have Medicare only, you get all of your health care benefits, including prescription drug coverage, through your PACE plan. You pay a monthly premium that is reduced because it doesn’t include prescription drugs. You will also pay a separate Medicare prescription drug premium to cover the cost of your prescription drugs.
If you don’t have Medicaid coverage, you may still qualify for extra help paying for Medicare prescription drug coverage. If you think you may qualify, call Social Security at 1-800-772-1213, visit www.socialsecurity.gov on the web, or go to your State Medical Assistance (Medicaid) office and fill out an application for extra help. For more information about this extra help, see pages 19–28.
- Page 19: Ways you may qualify for extra help - Automatic
- Page 20: Medicare Drug Plan Costs if You Automatically Qualify for Extra Help
- Page 21: Ways you may qualify for Extra Help - Apply
- Page 22: Medicare Drug Plan Costs if You Apply and Qualify for Extra Help
- Page 23: Applying for Extra Help
- Page 23: What income counts?
- Page 24: What resources count?
- Page 24: What happens after I apply for extra help?
- Page 25: How long will I get extra help if I qualify?
- Page 26: What If my extra help application is denied?
- Page 27: What if I don’t qualify for extra help?
(Primary Source: Centers for Medicare and Medicaid Services - Your Guide to Medicare Prescription Drug Coverage 2008. This content may have been enhanced by this site to include further examples, explanations, and links.)