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MEDICARE PART-D

MEDICARE Part D Annual Enrollment Period is NOVEMBER 15 thru DECEMBER 31.

  • Medicare beneficiaries already enrolled in a drug plan can switch to a different plan, with coverage effective January 1.
  • Medicare beneficiaries can also change between original Medicare with a drug plan and a Medicare Advantage plan with prescription drug coverage (MA-PDP).
  • To enroll in a Medicare Part D plan, you must have your Medicare number, effective date of Medicare Part A coverage, date of birth, zip code and a list of all medications including  dosages and strengths.

Low Income Subsidy


ANYONE WHO HAS MEDICARE can get Medicare drug coverage. Do you know someone who is on Medicare and needs assistance in paying for their prescription drugs? 

Medicare beneficiaries may be eligible for the federal “Extra Help” Low Income Subsidy (LIS) program if he/she has limited income and resources. The Extra Help program can pay for all or part of the monthly premiums, annual deductibles and Medicare Rx drug cost. To qualify for Extra Help, the annual income limit is $15,600 ($1,354 monthly) for an individual and $21,000 ($1,821 monthly) for a married couple living together. Additionally, the total resources limit is $11,990 for an individual and $23,970 for a married couple living together. The resource limit does not include a primary home or a vehicle. If you believe someone you know may qualify for the Extra Help program, please encourage them to apply on-line at www.socialsecurity.gov , contact the local Area Agency on Aging Office or call our office toll free at 800-868-9095 to seek assistance with completing the on-line application or to request a paper application.

IF YOU DO NOT QUALIFY FOR the “EXTRA HELP” PROGRAM,

YOU MAY BE ELIGIBLE FOR GAPS

The Gap Assistance Pharmacy Program (GAPS) for senior citizens, age 65 and older, is administered by the South Carolina Department of Health and Human Services (DHHS) to provide assistance with the Medicare Part D prescription drug coverage gap.   If your prescription costs reach the Medicare Part D “coverage gap or doughnut hole" the GAPS program will pay 40% (2010) of the cost of covered drugs during the coverage gap.  In 2010, seniors eligible for GAPS will pay approximately 60% of their prescription costs during the gap. To qualify, the monthly income limit is $1,805 for an individual and $2,429 for a married couple living together. More information about GAPS and an application for the program can be found on the website for the South Carolina Department of Health and Human Services (DHHS), or call DHHS toll-free at 1-888-549-0820. You can also complete the GAPS application on-line at www.scaccesshelp.org, and then click on eforms.

THINGS TO REMEMBER

  • If you missed your Medicare Part B enrollment date, you can enroll in Part B during the general enrollment period which is January 1 through March 31 yearly; the effective date of coverage is July 1.
  • Check with your doctors before enrolling in a Medicare Advantage plan to be sure the plan is accepted. 
  • Medicare Part A deductible is $1,100.  Know if you can afford Medicare Advantage plans’ copays and deductibles for hospital stays.  Please pay close attention to all copays and deductibles.