Health ... Insurance Issues
Cuts in Prescription Drug Plans Coming?
By Yale Hauptman, Hauptman Law
Here in New Jersey our new governor, Chris Christie, is making some tough, and unpopular, decisions in an effort to close a huge state budget deficit. While I have written previously about his focus on reducing teachers’ pensions and benefits, a fight that is expected to continue, the latest changes focus on a program that provides prescription drugs to low income seniors and the disabled.
We have a lot of negatives to contend with here in New Jersey. You can start with the highest property tax and automobile insurance rates in the country and an overall high cost of living and go from there. However, the Pharmaceutical Assistance to the Aged and Disabled (PAAD) and the Senior Gold programs that we have here are among the most generous programs of their kind that can be found anywhere in the nation. In fact, fewer than 20 states offer comparable programs.
What makes these programs so good is the income levels needed to qualify. For PAAD in 2010 one must have no more than $24,432 per year in income for an individual and $29,956 for a married couple. Senior Gold income limits go up to $34,432 for an individual and $39,956 for a married couple. There is no asset limit. Participants in PAAD pay $6 per generic prescription drug and $7 per name brand drug. The Senior Gold co-pay is $15 plus 50% of the remaining cost of the prescription or actual drug cost, whichever is less. But that’s what is going to change.
Under Governor Christie’s plan, beginning in January 2011, there would be a $310 per year deductible per person. The co-pay for brand name drugs would also increase from $7 to $15 while the co-pay for generic drugs would drop from $6 to $5. While there are approximately 165,000 people participating in PAAD, it appears that the 40,000 lowest income participants would be exempt from this increase.
Nevertheless, this latest news is just another example of the belt tightening that is going on everywhere and is just another reason why, as our population ages and more Americans reach senior status, it is so important to be proactive in planning for long term care rather than simply waiting for something to happen before addressing the need. You want to get to the front of the line because it is all to easy to get pushed to the back.