Medicaid
Medicaid is a state health insurance program for people with low income. Also known as HUSKY, it provides a comprehensive health care benefits package which includes prescription drug coverage.
Eligible individuals enrolled in HUSKY A, C and D can receive most of their medications at no cost while HUSKY B members may have a co-payment requirement. HUSKY doctors prescribe generic drugs when available.
Learn More: Visit the HUSKY Healthcare website for more information, how to qualify and how to apply.
Dual Eligibility
Some individuals are eligible for and enroll in both Medicaid and Medicare. In this case, guidelines for prescription drug coverage will change. Medicaid will no longer cover the costs of most medications; it will instead be covered by a Medicare Part D drug plan.
Go here for more information on how dual-eligibility affects prescription drug coverage.
Medicare Prescription Drug Coverage
Medicare Prescription Drug Coverage is available to everyone who has Medicare Part A and/or Part B. While neither Part A nor Part B covers the cost of outpatient prescription drugs, there are two main options available to get that coverage. The first is the purchase of a stand-alone Medicare Part D prescription drug plan to supplement Parts A and B. Most states, including Connecticut, have between 20 and 30 different Part D plans available for purchase from private insurance companies. Premiums, deductibles and co-pays can vary widely among the plans, so it’s best to compare the plans in light of your budget and projected prescription use.
The second option is enrollment in a Medicare Advantage plan (also known as a “Part C” plan.) Most Medicare Advantage plans cover all Medicare benefits, including drugs, and are also sold by private insurance companies. Premiums and coverage also differ for these plans.
It’s advisable to re-evaluate Medicare coverage each year during the annual “open enrollment” period. This is when individuals may enroll in, switch, or depart from Medicare Advantage plans and the Medicare Part D prescription drug plan. Your current plan or your medications may have changed and a different plan may better meet your needs or your budget in the following year.
Learn More: Visit Medicare.Gov for more information.
Or Contact CHOICES: Connecticut’s program for Health insurance assistance, Outreach, Information and referral, Counseling, Eligibility Screening. Visit the CHOICES website or call 1-800-994-9422 for information, referrals, eligibility screening and counsel.
Extra Help paying for Medicare Part D
Financial assistance is available to cover some or all of the costs of Medicare Part D. Extra Help, also known as the Low-Income Subsidy (LIS), is a federal program that covers some or all of the costs of monthly premiums, deductibles and cost-sharing for a Medicare Part D plan.
Most people qualify for LIS because they are enrolled in the Medicare Savings Program or HUSKY Medicaid insurance. The Medicare Savings Program pays the Medicare Part B premium and may also pay for the deductibles and cost-sharing of Medicare Part A and B benefits. Learn more and apply for the Medicare Savings Program here.
Some people choose to enroll in LIS through Social Security if their income and assets meet the financial criteria. Go here to apply for LIS or call Social Security at 1-800-772-1213.
