Senior Gold Prescription Discount Program

Senior Gold Prescription Discount Program

· Members receive assistance for prescribed legend drugs, insulin and insulin supplies.

· Senior Gold does not pay for diabetic testing supplies (e.g., test strips and lancets). If Senior Gold beneficiaries have health insurance coverage, such as Medicare Part B that pays for diabetic testing supplies, a pharmacy must bill that insurance plan. Senior Gold will not pay for them.

· Members pay a copayment of $15 plus 50% of the remaining cost of each Senior Gold covered drug.

· Once members reach annual out-of-pocket expenses exceeding $2,000 for single persons or $3,000 for married couples, they pay only a flat $15 copayment per prescription for the balance of that eligibility period.

· A Senior Gold beneficiary must be a New Jersey resident.

· A Senior Gold beneficiary must be 65 years of age or older, or at least 18 years of age and receiving Social Security Title Disability benefits.

· A Senior Gold beneficiary must have annual income for 2022 between $38,769 and $48,769 if single or between $45,270 and $55,270 if married

· All Medicare-eligible Senior Gold beneficiaries must participate in Medicare Part D. Senior Gold beneficiaries must pay the monthly premium directly to the Medicare Part D plan of their choice. They also are responsible for paying any late enrollment penalty imposed by Medicare for each month they were eligible to enroll in Medicare Part D but did not enroll.

· Senior Gold benefits help to make Medicare prescription drug coverage more affordable by reducing any other out-of-pocket costs associated with that coverage, such as deductibles, co-insurance, and the coverage gap known as the "donut hole."