Medicare officials estimate as many as 7,000 Utahns who qualify for a subsidized prescription-drug program don't know about it. And the federal government is serious about finding those folks.
Medicare public affairs specialist Mike Fierberg, like his counterparts in other regions, has been making the rounds of newsrooms and organizational meetings to talk about the benefit, which pays at least 75 percent of a qualified beneficiary's medication costs.
The average enrollee in the program will save $3,000 a year, he said. Many of the people who qualify are the same folks who qualify for the economic stimulus payment and have not filed; Fierberg says of the more than 12,000 Utahns who have not filed for their stimulus payment, 65 percent are 65 or older.
The majority of beneficiaries of the pharmaceutical benefit, called the Low Income Subsidy (LIS), have already been found and automatically enrolled because they qualified for other programs, including Social Security benefits because of a disability or Medicaid. The missing folks have somewhat higher income up to 150 percent of federal poverty guidelines, Fierberg said. Because they don't qualify for other assistance, they may incorrectly assume there's no help for them.
The benefit is potentially significant. It pays most prescription costs, with a few exceptions. Beneficiaries do not pay the Part D monthly Medicare premium. And co-payments for prescriptions are typically $2.25 a month for generic and $5.65 for brand-name products.
"Congress intended it to be an extremely rich benefit and it is," Fierberg said.
You can apply at your local Social Security office or call and have a form mailed to you. You can also access form 1020 online through ssa.gov. The benefit starts as soon as you qualify and if a qualified individual has not applied already for Part D Medicare, there's no penalty to do so now to get into the program.
Not all Part D plans are allowed with the LIS program, so some people may end up switching plans to access this benefit. There are at least a dozen plans in Utah to choose from if needed, Fierberg said.
The fed's "best guesstimate" indicates 2,893 low-income seniors in Salt Lake County are eligible, along with 638 in Weber County, 840 in Utah County, and 281 in Davis County. Cache County has an estimated 157, while Washington County has 289. The numbers, which seem precise, are estimates extrapolated from Social Security, Census and Internal Revenue Service data.Besides income eligibility, there's an asset test that does not count home, car and personal property, but limits cash or cash-equivalent assets to $12,000 for an individual and $24,000 for a couple.