County offers assistance with drug plan paperwork Seniors or their caregivers who may need help in navigating changes to the Pharmaceutical Assistance for Aged and Disabled (PAAD) and Senior Gold programs can find it at the Ocean County Office of Senior Services. "There are over 18,000 PAAD and 3,400 Senior Gold beneficiaries in Ocean County," said Ocean County Freeholder Director Joseph H. Vicari, who serves as chairman of senior services. "All of these people are important members of our community and deserving of the best help available." According to Vicari, members of PAAD and Senior Gold began receiving letters last week informing them of changes to the programs. To be eligible for the PAAD program as a single individual, a person's income must be no more than $23,092 and as a married individual, no more then $28,313. Single individuals with incomes under $33,092 or married individuals with incomes under $38,313 are eligible for the Senior Gold program. "Senior Gold benefits help to make Medicare prescription drug coverage more affordable by reducing any other out-ofpocket costs associated with that coverage," Vicari said. "This includes deductibles, co-insurance and the coverage gap known as the 'donut hole.' " Starting Aug. 1, individuals on PAAD will be responsible for a $6 co-payment for all generic drugs and a $7 co-pay for brand name drugs, up from the previous $5 fee. PAAD will continue to pay members' Part D premiums and certain beneficiaries may pay less for generic drugs if their Medicare prescription drug plan charges them less than the new $6 co-payment through PAAD. Also beginning Aug. 1, PAAD and Senior Gold will no longer pay for diabetic testing supplies such as test strips and lancets. However, if any PAAD and Senior Gold beneficiaries have health insurance coverage such as Medicare Part B, their diabetic testing supplies will be covered and the pharmacy must bill that insurance plan. Effective Aug. 1 as well, all Senior Gold beneficiaries who are eligible for Medicare Part A, or enrolled in Medicare Part B, are required to enroll in a Medicare drug plan. They must enroll by Sept. 30 or they will be terminated from the program, according to a press release. Senior Gold beneficiaries who are eligible for Medicare are also responsible for paying the monthly premium directly to the Medicare Part D plan of their choice. If they incur any late enrollment penalties imposed by Medicare, they will be responsible for those charges. The penalty is 1 percent per month of the average annual premium for every month they delayed. Vicari noted that the Senior Gold program has matched each beneficiary through his or her current prescription drug usage and pharmacy preference with a standard or basic Medicare Part D plan in New Jersey with which Senior Gold is working. They may enroll in this plan, or choose any other Medicare Part D plan that meets their needs. Regardless of which plan beneficiaries enroll in, they should notify the Senior Gold program of their enrollment. "Senior Gold beneficiaries are members of a qualified state pharmaceutical assistance program which means they are entitled to a special enrollment period in 2008 for Medicare Part D," added Jane Maloney, director of senior services. "They can, and should, enroll in Medicare Part D right now if they are eligible to do so. They should not wait until the next annual enrollment period begins on Nov. 15." However, Maloney noted there are some beneficiaries who may have creditable coverage. This means they have prescription coverage for themselves, are covered under a spouse's plan or through a retiree or union health plan. In this case, the beneficiary is not required to enroll in a Medicare prescription drug plan. But, in order to continue using his or her Senior Gold benefits, the beneficiary must mail a copy of their former employer's or union's notice prohibiting him from enrolling in Medicare Part D, along with a copy of the front and back of the plan's membership card to: Senior Gold, P.O. Box 724, Trenton, NJ 08625. Veterans coverage is creditable coverage; proof of the coverage should also be mailed to: Senior Gold, P.O. Box 724, Trenton, NJ 08625. Some Senior Gold beneficiaries also have a Medicare Advantage plan. Under this plan, the health insurance benefits received through Medicare Parts A and/or B are provided by a Health Maintenance Organization (HMO) or another private insurance plan. When a person belongs to a Medicare Advantage plan, he/she can only obtain the Medicare Part D drug benefits from that same Medicare Advantage plan. Therefore, Senior Gold members who are covered under a Medicare Advantage plan should contact a plan representative immediately for instructions on how to add a prescription drug benefit to their existing Medicare health insurance coverage. It is also important to remember that with a Medicare Advantage plan, the person will be responsible for paying the premiums for both medical coverage (Medicare Part B) and prescription coverage (Medicare Part D). If the beneficiary does not take action now to add prescription coverage to his Medicare Advantage plan, he/she risks losing his Senior Gold benefits, according to the press release. If a Senior Gold beneficiary is enrolled in a Medicare Advantage plan, he/she should mail a copy of the front and back of his membership card to: Senior Gold, P.O. Box 724, Trenton, NJ 08625. "The Ocean County Office of Senior Services and the Outreach network are ready to assist individuals through this complex process," Vicari said. "We are offering support to any and all individuals who need it." Assistance is available at the Ocean County Office of Senior Services at 1027 Hooper Ave., Building No. 2, Toms River; the County Connection at the Ocean County Mall, Toms River; and at Outreach sites throughout the county. For additional information call the Office of Senior Services at 732-929-2091, 1-800-668-4899 or 1-877-222-3737 or visit the Senior Services Web site at co.ocean.nj.us.