New Jersey Senior Gold Assistance Program- What You Need to Know
Many New Jersey Medicare beneficiaries have high deductibles and costly coinsurances on their prescription drugs, even when they have a Part D, drug insurance. Assistance programs are available in New Jersey for residents with a low to moderate income.
Senior Gold is state assistance program that helps with the soaring cost of prescription medication. The New Jersey state-funded program helps create a different, more manageable co-payment structure for those that are eligible and in need.
Who Is Eligible for Senior Gold in New Jersey?
Eligible recipients have to meet a few requirements to apply, including:
- You must have an annual income (for 2020) between $28,400 and $38,399 if single and $34,818 and $44,817 if married.
- You must be aged 65 or older, or at least 18 and receiving Social Security Disability benefits.
- You must be enrolled in a Medicare part D plan of your choice.
- You are a NJ resident
How Does Senior Gold Go Hand in Hand with Medicare Part D?
Part D is Medicare's prescription plan, and it's managed by approved private insurance companies. You pay a separate premium for it, and it helps to handle prescription expenses that Original Medicare does not cover. There are different phases of the drug coverage including the deductible, initial coverage phase, coverage gap or “donut hole”, and catastrophic. During the coverage gap or “donut hole” phase of coverage you pay 25% of the cost of the medication. The Senior Gold system in New Jersey was developed to help close that gap for you.
It works like this:
- You receive your Senior Gold card within 30 days of approval.
- When you go to pay for prescriptions, you pay a $15 copay plus half the remaining cost of any Senior Gold-approved medication that Part D didn't cover.
- Once your expenses for the year exceed $2000 for singles and $3000 for couples, the most you pay is $15 per medication for the rest of the year.
You do have some responsibilities when it comes to your Medicare Part D coverage as this goes on, though:
- You must still be enrolled in Medicare part D to continue using Senior Gold.
- You are still responsible for your Medicare part D premium.
- If you have a late enrollment penalty for not having drug coverage when you were first eligible you are still required to pay the penalty.
What’s the difference between NJ PAAD and Senior Gold?
NJ PAAD and Senior Gold are managed by the same department at the state and have the same application. If your income is lower than the thresholds for Senior Gold then you will qualify for the more generous program called NJ PAAD which stands for Pharmaceutical Assistance to the Aged and Disabled. This program will pay for the monthly Part D premium on certain plans and eligible medications will not be more than $7. More information about Senior Gold and NJ PAAD is available here.
Consult with a Medicare Broker about Senior Gold.
It's possible you still have questions or concerns about your Medicare part D or the Senior Gold program, and before you brave a trip to the Social Security office, you can still talk with a professional. New Jersey Medicare Brokers can offer you free, unbiased advice and information on any of your Medicare questions or issues. Whether on the phone or in person, you can have access to their expertise virtually anywhere in the state.
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