A Department of Aging Press Release notes that with Part D and PACE or PACENET, cardholders will not experience any coverage gaps because they can use the Pennsylvania programs as secondary prescription coverage. This means that PACE and PACENET will pay for prescription medications not on the Part D plan's formulary and prescription medications filled during Part D coverage gaps, as long as the state programs cover the medication.

PACE beneficiaries will pay a monthly premium to one of six Medicare prescription drug plans selected by the state.  For PACENET cardholders with higher incomes, the prior $40 monthly deductible will decrease to no more than $32.59.

The new program will also benefit the 87,000 PACE and PACENET beneficiaries enrolled in Medicare Advantage plans, although the choices are complicated. Cardholders should receive a letter that discusses their options. Additional information and assistance is available through the PACE toll free number listed below.

PACE and PACENET beneficiaries who have retirement plans that provide prescription drug coverage will not enroll in the new program.

PACE and PACENET cardholders who do not opt out of the program will receive a prescription card from their Medicare Part D plan.  Cardholders should show the Medicare card along with their PACE/PACENET card to their pharmacist.  The pharmacist will bill the Part D plan first and the PACE or PACENET program second. Cardholders do not have to keep track of their prescription expenses.

This means that PACE and PACENET cardholders will have two prescription cards - one from the state plan and the second from a Medicare Part D drug plan. On their initial visit to their pharmacy, cardholders should show both cards to the pharmacist. If the pharmacist has problems billing the medication, ask that PACE be immediately contacted by phone, while you wait.  

The state promises that no PACE or PACENET beneficiary will pay more under the new program. Savings for beneficiaries may be significant.  And, by effectively utilizing Medicare dollars, the program should save Pennsylvania money which can hopefully be used to expand the state programs.

Pennsylvania 's PACE Plus Medicare program provides benefits that are unavailable in most other states. Still, we see many clients who could qualify for the state prescription programs but are unaware of the benefits.

Qualification is based on income and you must be age 65 or older.  The income limits for PACE are $14,500 for individuals and $17,700 for married couples; and for PACENET $23,500 for individuals and $31,500 for married couples.  If you think you may qualify, contact your local Office of Aging or the PACE program at the number below.

Funded by the Pennsylvania Lottery, PACE and PACENET currently provide low-cost prescription assistance to nearly 312,000 Pennsylvanians age 65 and older. PACE now covers over 184,000 older adults and PACENET covers nearly 128,000. 

Cardholders with questions about PACE Plus Medicare should call PACE/PACENET, toll-free, at 1-800-225-7223. They may also visit the Department of Aging's Web site at http://www.aging.state.pa.us and click on the blue and gold PACE card or choose the link titled "PACE Plus Medicare." 

Jeff Marshall is Certified as an Elder Law Attorney by the National Elder Law Foundation and is the author of Elder Law in Pennsylvania. He is the managing attorney of the Elder Law Firm of Marshall, Parker & Associates' with offices in Jersey Shore, Williamsport, Clarks Summit and Wilkes-Barre.  He can be contacted at webmail@paelderlaw.com.

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