Medicare Supplement or Medigap Policies in Pennsylvania

Pennsylvania requires insurers to offer at least one Medicare Supplement policy to adults under sixty-five.  Pennsylvania does not mandate continuation coverage for small employers

 

State Pharmaceutical Assistance Program

Pennsylvania has several pharmaceutical assistance programs

• PACE and PACE Needs Enhancement Tier (PACENET), support for elderly, low-income Pennsylvanians both on and off Medicare.  For more, please see http://www.aging.state.pa.us/portal/server.pt/community/prescription_assistance/17942

• Special Pharmaceutical Benefits Program, helping Pennsylvanians afford drugs for schizophrenia and AIDS

http://pa.thebeehive.org/health/paying-health-care/special-pharmaceutical-benefits-program-spbp-pennsylvania

State Medicare Savings Programs
Pennsylvania has three Medicare Savings Programs:

• Qualified Medicare Beneficiaries (QMBs): For individuals with a monthly income under $903 and for couples with a monthly income under $1215, the state pays all premiums for Medicare Part B and all Co-Pays and Deductibles for Part A & Part B.

• Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with income under $1083 or couples with income under $1457, the state pays premiums for Part B.

• Qualified Individuals (QIs): For individuals with income under $1219 or for couples with an income under $1640, the state pays premiums for Part B.

To qualify for any one of these programs, participants must have assets below $6,600 or be part of a couple with assets below $9,910.

State Health Insurance Assistance Program
The APPRISE Health Insurance Counseling and Assistance Program operates a toll-free telephone system with call centers in 11 AAAs throughout the state. State grants to local sponsors fund a paid coordinator at locations throughout the state and support other related SHIP activities. APPRISE coordinates with community partners throughout the State to enhance information dissemination to beneficiaries as well as promote volunteer participation in the program. 


High-Risk Pool
Pennsylvania does not have a state-run high-risk insurance pool.

Low-Income Subsidy (“extra-help”) for Prescription Drugs
This program is a subsidy for Part D recipients with resources under $13,070 (or $26,120 for a couple) to receive money towards a Medicare prescription drug plan. The benchmark of support is different depending on which region of the country you live in. In Pennsylvania in 2012, the low-income subsidy was $34.32 per month.

 

If you live in Pennsylvania, and you are interested in getting a Medicare Plan, please contact the Medicare experts at eAmeriFamily Insurance.  They are industry veterans and will guide you through the process of getting the right Medicare, Medicare Advantage, or MediGap Plan for you.