NJ expands access to prescription drug discount programs

TRENTON, NJ – More seniors and residents with disabilities in New Jersey are eligible for state prescription drug discount programs thanks to a $10,000 increase in income limits for the programs.

Changes to income limits, announced on January 6, expand access to Seniors and Disabilities Pharmacy Assistance Programs (DADPs) and Senior Gold Prescription Discount Pharmacy Assistance Programs, benefiting more than 20,000 additional residents .

The income limits for the PAAD program are now $38,769 if single and $45,270 for a couple. The Senior Gold Prescription Discount program limits are now $48,769 if single and $55,270 if married. Assets are not an eligibility consideration for either program.

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This is the largest one-time increase in the programs’ history, state officials said.

“Cost shouldn’t be a barrier to medicine,” said Louise Rush, director of the state Department of Human Services, Division of Aging Services. “By expanding income eligibility for the PAAD and Senior Gold Prescription Assistance Programs, we’re opening up those savings to more residents who need help.”

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The change comes as prescription prices continue to rise much faster than inflation. In 2020, prices for 260 commonly used drugs rose 2.9% while the general rate of inflation was 1.3%, according to an AARP report.

“It’s unfair that drug prices continue to rise, even for drugs that have been on the market for decades,” said Leigh Purvis, director of healthcare costs and access at AARP. This report found that the total retail prescription drug cost for the typical older American who takes four to five prescription drugs per month would be $31,000 per year, more than the average annual income of $29,650 for Medicare beneficiaries.

The cost of Victoza, a diabetes drug, rose 42% from 2015 to 2020, from $7,936 to $11,300 for one year of medication, according to AARP, which has tracked prescription prices since 2006. Lyrica, used to treat fibromyalgia, rose 47% from $5,827 per year to $8,562.

Rising costs for basic needs have only added pressure on residents’ budgets, which may mean that older residents and people with disabilities have to choose between their medications and food or needs basic.

The PAAD and Senior Gold Prescription Discount Medication Assistance Programs are available to residents 65 and older and those with disabilities. PAAD reduces prescriptions to $5 for covered generic drugs and $7 for covered name brands. Senior Gold cuts prices in half after $15 co-pay for covered prescriptions.

“Few issues have a greater financial impact on New Jersey families than the ever-increasing cost of prescription drugs,” Gov. Phil Murphy said in announcing the increased income limits. “Making New Jersey a more affordable place to call home means working to lower the cost of prescription drugs. I am extremely proud of the progress we have made with this historic benefit increase that will extend benefits to thousands of New Jerseyans.

The PAAD, established in 1975, was the first national program for seniors, according to the National Conference of State Legislatures. New Jersey is one of 22 states with similar grant programs; 27 others have discount programs to help with prescription costs.

Senior Gold began in 2001 using funds from New Jersey’s part in the 1998 settlement between several states and five major tobacco companies over the health risks associated with smoking, NJ Spotlight reported.

More than 138,000 New Jersey residents were enrolled in both programs in 2019, according to the NJ Spotlight report.

Both programs are designed to work in conjunction with a Medicare Part D plan, so individuals must be enrolled in Medicare Part D. Part D serves as the primary payer and Senior Gold or PAAD serves as the secondary payer.

“We know that when budgets are tight, individuals face tough decisions like stretching their medications or leaving prescriptions unfilled,” said Sarah Adelman, acting commissioner of the New Jersey Department of Human Services. “This historic benefit increase will allow many senior residents and people with disabilities to qualify for prescription savings for the first time.”

The income limits for the Lifeline Utilities Assistance Program and the Hearing Aid Program for the Elderly and Disabled (HAAAD) have also increased by $10,000, as these programs are linked to the PAAD.

Senior residents and eligible persons with disabilities are encouraged to apply now through the NJSave online application, download an application from the NJSave webpage, or request a paper application by calling 1-800-792-9745. Online and paper applications are available in English and Spanish.

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