PAAD: New Jersey's Prescription Assistance Program
Many New Jersey residents find that once Original Medicare kicks in, prescription medication costs can be unaffordable. Although Medicare has coverage for medications through Part D this part of Medicare can leave high out of pocket costs, especially for brand name medications.
Medicare Part D is an additional policy, with a premium, that focuses specifically on prescription drug costs. For some, assistance needs to go a step further, and this is where prescription assistance programs like the Pharmaceutical Assistance to the Aged and Disabled program (or PAAD) come in.
Who Is Eligible for PAAD in the State of New Jersey?
PAAD is designed to help eligible New Jersey Medicare recipients save even more money on their prescription drug costs. Specifically, PAAD is there to assist low-income recipients who earn less than those who qualify for the Senior Gold program. Eligibility requirements are as follows:
- You must be a New Jersey resident.
- You are aged 65 or older, or you are between the ages of 18 and 64 and are receiving Social Security disability benefits.
- In 2020, you must have earned less than $28,399 if single or $34,817 if you are married.
- You must be enrolled in Medicare Part D.
- You cannot be on Medicaid, which has its own programs to help eligible recipients. This includes Managed Long Term Services and Supports (MLTSS) and NJ FamilyCare.
How Does New Jersey's PAAD Work with Medicare?
When you are enrolled in PAAD, the program pays for certain Medicare part D plans in New Jersey that meet an established regional benchmark, but the program can accommodate plans that sit up to $20 above that. PAAD has a $5 copayment for generic drugs, $7 for brand name drugs, and will cover necessary medication costs of anything above that copayment, so it keeps the cost of your medications simple and easy to track.
Drugs that are not covered by a patient's specific Medicare part D plan are not out of the question; if you or your doctor cannot find an approved alternative, the doctor can submit a request for an exception to be made. There are no costs to participate, and services should also help cover premiums and deductibles on top of drug costs.
Consult with Medicare Brokers about PAAD.
Programs and plans can shift, change, and disappear every year, and you want to stay ahead of that. If you have questions or concerns about your New Jersey Medicare coverage or assistance programs like PAAD, consider speaking with a specialist. A Medicare broker is an unbiased, informed expert who is there to answer any questions you have and provide all that you need to make informed decisions about your healthcare. The experts at New Jersey Medicare Brokers can work with you over the phone or video chat. Let them get you up to speed on changing programs like PAAD and others.