Medicare Part D and Low-Income Subsidy Program：医疗保险D部分和低收入补助计划.pptVIP

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Medicare Part D and Low-Income Subsidy Program：医疗保险D部分和低收入补助计划.ppt

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Medicare Part D and Low-Income Subsidy Program：医疗保险D部分和低收入补助计划.ppt

* * * * * * * * * * * * * * * * * * * * * * * * For those with Medicare or “Creditable Plan” Helps pay for drugs in the gap (for most members) Those in top income category (S5) must pay $200 annual fee for limited benefits All medications must be covered by primary plan Members are provided a SEP (one extra time each year outside of open enrollment to enroll or switch plans) Prescription Advantage does not pay late enrollment penalty fee How Extra Help and Prescription Advantage Lower costs Smart D Rx Plan Saver 2013 No Help PA S2 Partial Extra Help PA S1 Full Extra Help Premium $32.40 $32.40 Reduced Reduced $0 Deductible $325 $325 $66 $7/ $18 $0 Generics $0 $0 15% 15%/ $7 $2.65 Brands $35 $35 15% 15%/$18 $6.60 Non-preferred $85 $85 15% 15%/$18 $6.60 Cov Gap Generics 79% $7 15% 15%/ $7 $2.65 Cov Gap Brands 47.5% $18 15% 15%/$18 $6.60 Benzodiazepines Full cost $7/$18 Full Cost $7/$18 Full Cost 2013 Program Guidelines for Individuals MSP: QMB MSP: SLMB / QI Full Extra Help Partial Extra Help Prescription Advantage (S4) Part B Premium Automatic Full Extra Help Part D Premium Deductible paid for Copays no more than $6.60 Part D Premium, Deductible, Copays, reduced Help in coverage gap A B deductibles and copays Part B Premium Automatic Full Extra Help Single: $978 $7,080 Single: $1,313 $8,580 Single: $1,457 $13,300 Single: $2,873 no asset test Single: $1,313 $7,080 2013 Program Guidelines for Couples MSP: QMB MSP: SLMB / QI Full Extra Help Partial Extra Help Prescription Advantage (S4) Part B Premium Automatic Full Extra Help Part D Premium Deductible paid for Copays no more than $6.60 Part D Premium, Deductible, Copays, reduced Help in coverage gap and Benzos A B deductibles and copays Part B Premium Automatic Full Extra Help Couples: $1,313 $10,620 Couple