Massachusetts Prescription Advantage Program

The Commonwealth of Massachusetts Executive Office of Elder Affairs administers the Prescription Advantage Program in the state of Massachusetts. It is a state-wide program and aims to provide drug assistance to senior citizens or people with disabilities. Recipients of both the Medicare and non-Medicare healthcare services can qualify for the program. Through the program, these individuals are given financial assistance to pay for their prescription drugs. Individuals enrolled in the Medicare Part D plan or the Medicare Advantage plan can apply for the Prescription Advantage Program.

You should know that the first payer for your health care coverage is the Medicare program and the Prescription Advantage Program try to cover any financial gap. The program usually pays for low-cost drugs and prescriptions that might not be covered by Medicare coverage.

The main goal of the program is to make healthcare accessible to the senior citizens who are usually unable to pay for their medical prescription because it is expensive. Most of these adults have some form of disability or are unable to work or have a very low monthly income which makes it difficult for them to pay for the prescription drugs. Discontinuing your medication can lead to serious health problems and create complications especially for adults. It can increase the rate of strokes and heart attacks leading to the hospitalization of the patient which further increases their medical expenses.

Drugs that are part of a patient’s primary medical plan are covered under the Prescription Advantage Program. The program also covers any prescription drug that is for only one time and is not covered under the patient’s primary medical plan.

The Prescription Advantage Program asks for certain information at the time of processing your application form including the Medicare number (for applicants who are receiving the Medicare benefits), any other health care coverage that you might be receiving at the time of apply for the Prescription Advantage Program and railroad retirement information if needed.

Individual who are receiving Medicare Part A or B coverage are required to send copies of their Medicare ID number as well as copies of your insurance card ( both front and back ) for drugs that are been paid through any other healthcare coverage.

If an individual does not receive Medicare coverage, the Prescription Advantage Program acts as their primary health care coverage paying for their medically prescribed drugs and covering other healthcare expenses. The individuals have to pay a small amount or opt for co-payment. There is also an annual charge of a small amount for individuals enrolled in the Massachusetts Prescription Advantage Program and it does not count for the patient’s eligibility for the Medicare coverage. Every individual’s out-of-pocket limits depend on their total household income level.

Individuals who do not fulfill the Medicare requirements are still eligible to apply for the Prescription Advantage Program if they are 65 years of age or older and their gross household income falls within or under 500% of the Federal Poverty Level. Individuals with healthcare coverage other than the Medicare coverage which is also well-known in the state can also apply for the Prescription Advantage Program. In some cases, adults who are younger than 65 years of age with a maximum of 40 hours of work hours limit each month and have some form of disability can also apply for the Prescription Advantage Program. It should be noted that the disability should fall under MassHealth’s guidelines and the total household income should be 188% or less than the Federal Poverty Level.

To reach out to the Massachusetts Prescription Advantage Program’s office you can call at the following numbers -(800) 243-4636, (877) 610-0241 (For TTY users)

Also Read: Alabama Home Health Program