OLR Report 2012-R-0171 describes other states' pharmaceutical assistance programs similar to ConnPACE.
ConnPACE is a state-funded pharmaceutical assistance program that helps eligible senior citizens and people with disabilities afford the cost of most prescription medicines, as well as insulin and insulin syringes. Eligibility for the program requires Connecticut residents to (1) be age 65 or older, or younger and have a permanent disability; (2) be ineligible for Medicare; and (3) have income under $26,000 if single and $35,000 if married.
Prior to 2011, ConnPACE was a “wraparound” program for individuals receiving Medicare Part D (pharmacy) benefits. Currently, ConnPACE eligibility is limited to those individuals who are ineligible for Medicare, thus the program provides benefits to a much smaller number of individuals. The state's Medicare beneficiaries now get “extra help” paying for prescriptions from the federal government. For a recent history of ConnPACE and changes related to Medicare Part D, see OLR Report 2011-R-0299.
When Medicare Part D was implemented in 2006, many states converted their pharmaceutical assistance programs to wraparound programs, which further limit the out-of-pocket expenses for Part D participants. In order to qualify for these wraparound programs, those eligible for Medicare must enroll in a Part D plan. Some states discontinued their pharmaceutical assistance programs altogether when the federal government began providing the extra help.
According to the National Conference of State Legislatures, 17 other states currently have pharmaceutical assistance programs for seniors or people with disabilities. State programs vary with respect to eligibility, benefits, and co-payments or premium costs. Some states require enrollment in Medicare Part D and others require an application for the federal extra help (i.e., Low Income Subsidy (LIS)). Income limits for eligibility are typically tied to some percentage of the federal poverty level (FPL) (100% of the FPL for one person in 2012 is $11,170).
For more information, including a table showing plans from 17 states, read the full report.
