CHAMPAIGN – If there's one major point the folks at Champaign County Senior Services would love to get across right now about the new Medicare prescription drug coverage starting next year, it's about the Social Security "extra help" application many people received in the mail:
Don't pitch it! Fill it out and return it, they urge.
"Many people are getting a Social Security application and throwing it away," said Lisa Renee Kemplin, senior solutions coordinator at Champaign County Senior Services in Urbana.
That application is one of the many points of confusion that have already popped up in connection with the new Medicare Part D drug coverage taking effect next year, according to Victoria Christensen, Champaign County Senior Services team leader. Here's why:
Currently, lower-income seniors receive help paying for their medications through two state of Illinois programs – Circuit Breaker and SeniorCare.
As of next year, those programs will no longer exist. They are being rolled into a new state program called Illinois Cares Rx, which will provide wrap-around coverage to fill the gap that might have left some low-income elderly people out in the cold in the new Medicare prescription drug program.
The federal extra help program will help pay for the cost of the new Medicare Part D monthly premiums and deductibles, and the new state program will offer reduced copayments for prescription drugs, Kemplin said.
To qualify for Illinois Cares Rx, however, she and Christensen say, seniors must first fill out the Social Security extra help application and enroll in Medicare Part D.
What's happening, they said, is that some people receiving the extra help application in the mail are throwing it away because they aren't aware that they must fill it out for their Circuit Breaker or SeniorCare assistance to roll into the new Illinois Cares Rx.
Or, people are looking at the Social Security extra help application and seeing they don't qualify for federal assistance – because it's based on their assets – as opposed to the state program, which is based on their income.
Because of the difference in how the two programs qualify people, it's possible to be rejected for federal extra help and still qualify for the state program, Christensen said.
Those people who get a rejection letter for Social Security extra help should save it and proceed with their application to Illinois Cares Rx, she advised.
Two other pitfalls for some who might qualify for Illinois Cares Rx:
– There were 769,394 Social Security extra help applications mailed to people in Illinois. But not everybody who qualifies for state of Illinois assistance got the Social Security application, so some people will need to pick one up on their own through Senior Services or another locations that serves the elderly and disabled.
– There are 29 approved Medicare Part D plans in Illinois to choose among, and people receiving state assistance will need to make sure they choose one that accepts Illinois Cares Rx.
It's also important to note, Kemplin said, that the new Illinois Cares Rx will continue to offer two other kinds of assistance that were offered under Circuit Breaker and SeniorCare – help paying for vehicle license plates and a one-time grant based on the cost of the recipients' rent, nursing home costs or property taxes. So people wishing to receive those two other kinds of state assistance will also have to go through the same application process as those in need of prescription drug coverage assistance.
Some of the details about how both Medicare Part D and Illinois Cares Rx will work are still unfolding, Christensen said, and there's not much time for both organizations like hers and Medicare beneficiaries to get up to speed on all the changes taking effect Jan. 1, 2006.
"There's a huge piece of education that needs to be done, because it's so complicated," she added.