The
new rules will become effective
January 1, 2004
.
The new law raises the income limit for PACE eligibility to $14,500
for individuals and $17,700 for married couples.
PACE co-payments will change.
Participants will pay $9 for brand-name drugs instead of $6.
The co-payment for generics will remain the same at $6.
Co-payments will be indexed for inflation using the prescription
drug consumer price index.
The
PACENET program provides less generous benefits for seniors with higher
incomes. The PACENET income
limits will be raised to $23,500 for individuals and $31,500 for couples.
PACENET benefits will now begin after the participant has incurred
a $40 per month deductible in un-reimbursed prescription costs.
The $40 deductible is cumulative and applied to subsequent months
to determine eligibility. Thus, the annual total cumulative deductible
cannot exceed $480 per year. (Previously,
benefits began after a participant paid a $500 annual deductible). PACENET
participants have co-payments of $8 for generics and $15 for brand-name
prescriptions.
The
PACE legislation also contains a number of cost-containment measures.
The new law is available online at:
http://www2.legis.state.pa.us/WU01/LI/BI/BT/2003/0/HB0888P2919.pdf
(scroll down to
Section 519 for the revised eligibility rules).
Individuals
can obtain PACE/PACENET applications and even apply online at
http://www.fhsc.com/pennsylvania/paceenrollment/.
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