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Senior Notes - Medical Matters, Who is Eligible?, Medicare Recipients

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By Kieran C. O’Sullivan

Medical Matters

Prescription Advantage is a state-sponsored prescription drug insurance plan for Massachusetts seniors and disabled residents. For people on Medicare, Prescription Advantage helps pay Part D Prescription Drug Plan costs. For people not on Medicare, the program provides primary prescription drug coverage.

Who is Eligible?

To be eligible for Prescription Advantage, you must be a Massachusetts resident who is 65 years or older; or a Massachusetts resident under 65 who is disabled and meets the income and employment guidelines. Medicare recipients must join a Prescription Drug Plan (PDP) or a Medicare Advantage Plan with drug coverage, or have comparable coverage through an employer or union. You cannot join this program if you get prescription drug benefits through MassHealth. Your immigration status and your current state of health do not affect your eligibility.

Medicare Recipients

For Medicare recipients, Prescription Advantage offers supplemental coverage to help pay the costs of Medicare Part D Prescription Drug Plan coverage. Prescription Advantage helps with Medicare drug plan co-payments and limits annual out-of-pocket costs. The amount of help you will get from Prescription Advantage depends on your income.

For people not eligible for Medicare, Prescription Advantage offers primary prescription drug coverage. There is no enrollment fee and no monthly premium. Members pay quarterly deductibles and prescription co-payments, based on a sliding fee scale. Annual out-of-pocket costs are limited.
Application process

To apply for Prescription Advantage, you should call 1-800-AGE-INFO to get an application. You may also download an application from the Prescription Advantage web site, write to Prescription Advantage (P.O. Box 15153, Worcester, MA 01615-0153), or visit your local Council on Aging or SHINE office.

People with a Medicare Prescription Drug Plan (PDP) should bring both their PDP benefit card and their Prescription Advantage card when they buy prescription drugs. People not on Medicare use just their Prescription Advantage benefit card. You can use your Prescription Advantage card at retail pharmacies throughout the country. Prescription Advantage also offers mail order service so you can fill your prescriptions by mail, phone, or via the Internet. Massresources.org has a lot of other valuable information on its site and you can visit their site free of any charges for further information.

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