Medicare Part D - Help for Low Income

Beneficiaries eligible for both Medicaid & Medicare (dual eligible) with assets of $2,000 for single person and $3,000 for couples –

1. No monthly premium or annual deductible.
2. Beneficiary pays $1 for generic and $3 for brand name drugs if below poverty level, or pays $2 for generic or $5 for brand name drugs if income is above poverty level and below 135 percent of poverty level.
3. Medicare pays all other drug costs (no “gaps” in service).

Beneficiaries below 135 percent of poverty with higher assets ($6,000 for a single person and $9,000 for couples) –

1. No monthly premium or annual deductible.
2. Beneficiary pays $2 for generic or $5 for brand name drugs.
3. Medicare pays all other drug costs (no “gaps” in service).

Beneficiaries below 150 percent of poverty level, not eligible for above programs, and have assets below $10,000 for single person or $20,000 for couples –

1. Monthly premium based on sliding fee scale.
2. $50 annual deductible.
3. After the deductible, beneficiary pays 15 percent of drug costs for next $2,200 of drug costs.
4. Medicare pays until $5,100 of drug costs.
5. After $5,100 of drug costs, beneficiary pays $2 for generic or $5 for brand name drugs.