HARRISBURG, July 6, 2011 – State Sen. Wayne D. Fontana today lauded the new state law that protects thousands of PACE/PACENET recipients from losing their eligibility due to small Social Security cost of living increases.
“Prescription drug benefits are too critical to our seniors to lose over some small Social Security COLA,” Fontana said. “The new law (Act 21 of 2011) holds enrollees harmless for three years while the legislature continues to explore ways to increase eligibility and benefits.”
Fontana said PACE and PACENET provide comprehensive prescription coverage to seniors and covers most prescription medications, including insulin, syringes and insulin needles.
To be eligible for PACE or PACENET, one must be 65 years of age or older, a state resident for at least 90 days prior to applying for benefits, and cannot be enrolled in the Department of Public Welfare’s Medicaid prescription benefit. Eligibility for both programs is determined by previous year’s income.
To qualify for PACE, a single person’s income cannot total more than $14,500. For a married couple, combined total income must be less than $17,700. Once you are enrolled in PACE, you will be sent a benefit card and pay no more than $6 for each generic prescription medication and no more than $9 for each brand name prescription.
PACENET’s income limits are slightly higher than those for PACE. A single person’s total income can be between $14,500 and $23,500. A couple’s combined total income can be between $17,700 and $31,500. PACENET cardholders that do not enroll in a Part D plan will pay a nominal deductible each month at their pharmacy, which will be calculated through the cost of their medications. In addition, the individual will pay no more than $8 for each generic prescription medication and no more than $15 for each brand name.
“We need to make sure seniors can get the drugs they need,” Fontana said. “This law ensures that cost-of-living increases do not put someone over the income limits for PACE/PACENET, sometimes by just a few cents.”
Fontana said that without the change, about 9,000 people receiving PACENET would have lost their benefits, while an estimated 21,000 PACE enrollees would have had to move to PACENET, making them responsible for higher co-pays.