ConnPACE drug assistance program

ConnPACE and Medicare Part D for 2011

ConnPACE, the state pharmaceutical assistance program that helps those with low incomes has been effected by State of Connecticut budget cuts. And the news isn't good for my Medicare beneficiaries who have relied on their assistance for many years.

Many beneficiaries cannot afford to purchase Medigap coverage and a separate Part D drug coverage plan due to the higher monthly premiums. Medicare Advantage Plans that were signed into law by President Bush in 2003 were a blessing to many of those same beneficiaries. Medicare Advantage Plans, officially Medicare Part C, offer all the Medicare Part A & Part B benefits, plus lower deductibles and coinsurance in most cases. Most Advantage Plans also include the Part D drug coverage. Monthly premiums vary from $0 per month, up to around $180 per month. Traditionally, Medicare beneficiaries would fill the coverage gaps in Medicare Parts A & B with a Medicare Supplemental Insurance Policy (Medigap Plan). But the cost for the most popular Medigap plans runs about $170 to over $200 per months, and does not include the Part D drug coverage. Medicare Part D drug plans that include some generic drug coverage in the donut hole (Gap) start at about $50 plus. When you add that up, it comes to around $220 per month in premiums. So enrolling in a Medicare Advantage plan which included drug coverage, and having ConnPACE provide brand name and generic drugs in the donut hole, help out a lot of seniors with low incomes. ConnPACE also provided that no single drug, even name brands, would cost beneficiaries more than $16.25 for a 30 day supply. If the Part D plans copays were lower than that, you would be the lower price. It was a great program for those in need, and still is. Except now senior beneficiaries will need to spend more to get the same benefits they received prior to the new rules.

Unfortunately the new rules, which began in 2010, will not allow for ConnPACE to pay for Connecticut beneficiaries to who are enroll in a Medicare Advantage Plan's Part D drug plan premiums. ConnPACE now will cover only the premiums for a limited amount of Part D "stand alone" drug plans. This means that in order to benefit from a program that was originally intended to help those with low incomes, a Medicare beneficiary would have to purchase a Medigap plan, along with a stand along Medicare Part D drug plan. Of course the increase in what you would pay for this combination in comparison to the cost of many Advantage plans will nullify the benefits of the ConnPACE program for many of those low income residents it was designed to help in the first place.

We do not understand the logic, or how this will save the program money, other than by discouraging beneficiaries from applying for the program in the first place. The fact is, there are many connecticut seniors that simply cannot afford a Medigap and Part D drug plan combination. What is also strange to us, is that last year, the portion of Medicare Advantage Plan monthly premiums that were allocated to the Part D drug portion of those plans were usually less than the cost of the stand along Part D drug plans they will have to pay for under the new rules.

Please understand that ConnPACE can only pay the premiums on what are called "Benchmark" plans. Click here to see what those Benchmark plans are for 2011. The document that will open doesn't list all the Benchmark plans, only those that were accepted at the time of the publication. You will find those Benchmark plans highlighted in yellow.

If you click on the link to follow, you will be redirected to the ConnPACE web site.
click here to read the ConnPACE new rules article on the ConnPACE website