Actress Jasmine Guy has been delivering a Sunday message in churches in St. Louis and other parts of the country to the loved ones, caregivers and friends of senior citizens who are spending too much on prescription drugs. The extra help through Medicare Part D prescription drug plan could save seniors 75 percent or more on prescription drug costs.
Although most folks don’t like other people getting into their personal business—particularly about money matters – Guy said this is exactly what is needed in order for Medicaid to find the men and women who need their help.
“We’ve got to take that initiative because our people don’t want to talk about their many illnesses and their business,” said the star of the 80s sitcom, “A Different World. “We – my age and younger – need to talk to them.”
Many senior citizens struggle needlessly with how to pay for their prescriptions and it sometimes comes down to a choice between buying food or medicine. And it is not always comfortable to ask for help.
“It’s our job to make sure seniors in our community know about this discount,” Guy said. “It could wipe you out if you have to choose between paying your rent and getting your medication.”
St. Louis was the first stop for the Senior Savings Challenge targeting low income African Americans by the Centers for Medicaid and Medicare Services, partly because CMS estimates 6,000 to 7,000 elderly residents in the area could get the limited income subsidy for their medical prescriptions, but do not – either because they don’t know about the plan or are unaware of their eligibility.
But don’t simply take their word for it that they are not eligible – don’t believe it until you see it in writing.
“They are very reluctant to tell you things you need to know to help them. You must be persistent. Don’t allow the person to rely on ‘someone said,’” said Alice Logan, area director of the Eastern Missouri Social Security office. Determination of eligibility for the extra help is made by the Social Security office.“They need a formal decision. They need to present something to show they made an application and have reached a decision. If you are on Medicare, age 65 or older or a disabled person, find out if you qualify.”
Guy said ask directly, “Do you need help with your drug costs?”
“Don’t leave until you understand what they are talking about,” Logan said. “Until you are clear, because it affects your quality of life.”
“Even if you think you don’t qualify, go ahead and apply. There are some things that we don’t count towards income and you may qualify,” said Mark Gilbert, CMS regional administrator. ”When in doubt, fill it out.”
For example, the home you live in, vehicles, personal possessions, burial plots or irrevocable burial contracts are not counted toward income. Persons eligible for the extra help with Medicare prescription drug plan have an income of $21,000 or less for married persons living together or $15,600 for individuals. Resources are limited to $11,990 for an individual, or $23,970 for a married couple living together (Resources include such things as bank accounts, stocks and bonds). Note that in some situations, these limits may be higher.
Although the information is readily available online – the internet can be scary and confusing for those who don’t normally use online resources. That’s where CMS says you come in – by asking the tough questions to an elderly relative or neighbor and filling out an application for them online (with their permission) or by telephone at the Social Security office.
There are three basic steps to finding out if you or someone you know who has limited means qualifies for the Medicare prescription cost help.
1. Go to www.ssa.gov/prescriptionhelp , locate the “Apply Online” sexrion and click on the “Apply for Help” link to fill out the form;
2. Apply by phone or mail by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778), ask for form SSA-1020, fill it out and return it; and
3. Look for a written response in the mail from Social Security in a few weeks.
If you qualify, you will get help paying for your Medicare prescription drug plan’s monthly premium, as well as for deductibles and co-pays. The amount of extra help you would get is based on your income and resources, but could be worth as much as $3,600 per year.
There is no deadline with this aspect of Medicare (the extra help for prescription costs). CMS is waiving the rules to allow sign up for the limited income subsidy throughout the year.
“It’s up to us to reach at least one other person,” Guy told the Mt. Beulah congregation. “It does take a village – not just our babies, but for our seniors.”