PAAD: New Jersey's Prescription Assistance Program
*Updated 4/20/23 with the 2023 income limits*
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 New Jersey Pharmaceutical Assistance to the Aged and Disabled program (or PAAD) come in.
Who Is Eligible for PAAD in the State of New Jersey?
NJ 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 2023, you must have earned less than $42,142 if single or $49,209 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 NJ PAAD Work with Medicare?
- Eligibility: Once accepted, you will be eligible for the program for one year. After one year, you will be asked to re-certify your eligibility on an annual basis.
- Cost: There are no costs to participate in the NJ PAAD program, and services should also help cover premiums and deductibles on top of your monthly Part D prescription drug costs.
- Monthly Premiums for Part D coverage: When you are enrolled in PAAD, the program pays for certain Medicare Part D plans in New Jersey.
- Co-payments for prescription drugs*: You will pay no more than $5 copayment for generic drugs and no more than $7 for most brand name drugs at the pharmacy. The program 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 with the insurance company. You may also change your Part D plan if necessary due to your eligibility with PAAD.
Consult with Medicare Brokers about NJ 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 in person with any questions you may have. Contact us today!
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