The
Senior Rx Program is a state pharmaceutical assistance program for low-income
seniors and persons with disabilities who are Medicare eligible and do not
qualify for other services/programs, such as Extra Help or Medicaid.
Senior Rx is funded with a portion of Nevada’s share of
tobacco settlement funds and was passed into law during the 1999 Legislative
session. Program benefits for members are coordinated directly with
the Medicare Part D (PDP) or Medicare Advantage Plan (MAPD) that is contracted
with the Senior Rx program.
2021 Program Benefits:
- Provides a monthly subsidy of up to $37.00 for Medicare
Part D or Advantage Plan Part D premiums for eligible members (depending on the member’s
Part D plan and if not qualified for
maximum extra help from Medicare).
- Plan selection options for members that benefit their
individual health needs.
Program Changes Effective
January 1, 2020
- The Senior Rx Program is a Medicare Part D Premium
Subsidy Only Program.
- As a Part D Premium Subsidy Only Program, the Senior Rx
Program will pay the members monthly Part D Premium subsidy amount up
to$37.00 per month (depending on the member's Part D
plan)
- The Senior Rx program will no longer cover the cost of
medication while the member is in the Medicare Part D Gap/Donut Hole. With
an up to $37.00 monthly subsidy, Senior Rx members are encouraged
to evaluate and select a Part D Plan, or Medicare Advantage Plan with Part
D coverage, that best meets their individual health needs, and may reduce
their out of pocket costs.
Qualifications:
Eligible
for Medicare:
Applicants must be enrolled in a
participating Medicare Part D Plan (PDP) or a Medicare Advantage Plan including
Part D (MAPD). In addition, beneficiaries who qualify for
Extra Help with Part D costs (such as premiums, deductibles and co-payments)
must, if approved, use that help. This is important because the Extra Help may
cover more of the beneficiary’s out-of-pocket costs than the Senior Rx Program.
Beneficiaries with very low incomes and limited assets should contact the Social
Security Administration at 800-772-1213.
Age
Requirement: Senior Rx - Applicant
must be at least 62 years of age.
Income: Includes income from
all sources for both applicant and spouse. Effective July 1, 2019, the maximum
annual household income for singles is $30,556, and the maximum annual
household income for married couples is $40,732.Proof of income
is required when submitting a new application. Acceptable documents for proof
of income may include a copy of your current tax return, and/or credible documentation
of income source.
The Senior
Rx program may request two-months copies of your most recent bank statements (deposit
page only) to support income source.
The Senior
Rx program does factor in the current years IRS Standard Deduction when
calculating income.
Residency: Applicants must have lived continuously in Nevada for at least 12 consecutive months (one year) prior to the date of application.
If you think you qualify, complete the 2021 Senior Rx/Disability RX Application.
For additional Senior Rx information, call toll free 1-866-303-6323 option 2 or send an email to nvrx@adsd.nv.gov.
For unbiased FREE Medicare Counseling or to sign up for a Medicare Part D plan, please visit the State Health Insurance Program (SHIP) website or by call them at: Southern Nevada 800-307-4444 / Northern Nevada 877-385-2345
If you meet certain income and resource limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage. In 2020, you may
qualify if you have up to $19,380 in yearly income ($26,100 for a married
couple) and up to $14,610 in resources ($29,160 for a married couple). To
apply, contact the Social Security Administration at 800-772-1213 (TTY
1-800-325-0778) or Medicare at 800-633-4227.