BLOOMINGTON, IL — Fewer older adults and people with disabilities will be eligible for pharmaceutical assistance under the Illinois Cares Rx program — effective Sept. 1 — as a result of a cut in the recently approved state budget.
About 26,000, or 15 percent, of 175,000 current enrollees statewide may no longer be eligible for the program because of changes in income eligibility guidelines, said Mike O’Donnell, executive director of the Bloomington-based East Central Illinois Area Agency on Aging. In 16 counties covered by the area agency, 24,321 people are enrolled in Illinois Cares Rx and that includes 2,306 people in McLean County, O’Donnell said Wednesday.
Illinois Department on Aging, which administers the program, will send letters explaining changes to enrollees, he said.
The state budget, for the fiscal year that began July 1, funds Illinois Cares Rx at 50 percent of last year’s $107 million. The program is for low- to moderate-income people age 65 and older and people 64 and younger with a disability.
Because of the state cut, income limits have been lowered from $27,610 to $21,780 for a single-person household; from $36,635 to $29,420 for a two-person household; and from $45,657 to $37,060 for a three-person-or-more household. People who earn more than that may no longer be eligible for assistance.
For those still eligible, Illinois Cares Rx will continue to pay Medicare Part D premiums and deductibles. However, co-pays would increase from $2.50 to $5 for generic drugs, from $6.30 to $15 for preferred brand name drugs, and from $15 to $20 for non-preferred brand name drugs, O’Donnell said. The co-pay for specialty drugs would remain $15.
After the total cost of drugs (paid by enrollee and the plan) reaches $2,840, enrollees will pay 25 percent of the cost of each prescription, in addition to co-pays. Now, enrollees pay 20 percent after $2,830, O’Donnell said.
Changes have no effect on the Illinois Circuit Breaker property tax relief program, which continues using current income eligibility guidelines, O’Donnell said.
O’Donnell and Kathryn Johnson, assistant director of PATH (Providing Access To Help) Senior Services, recommended that enrollees determine whether their income has changed. If they are no longer eligible, PATH Senior Outreach workers can help enrollees in McLean, Livingston and DeWitt counties evaluate their coverage and advise them on other possible plans, Johnson said.
Help is available
For Illinois Cares Rx enrollees with questions about upcoming changes, help is available from:
• Health Benefits Hotline at 800-226-0768 and Senior HelpLine at 800-252-8966
• Senior Health Insurance Program (SHIP) at 800-548-9034
• www.illinoiscaresrx.com and www.cbrx.il.gov
• County outreach sites, including PATH in McLean, Livingston and DeWitt counties at 309-827-4005 or 211.
SOURCES: Illinois Department of Healthcare and Family Services, Kathryn Johnson, Mike O’Donnell
## AS posted by pantagraph.com,report; By Paul Swiech July 6, 2011
Read more: http://www.pantagraph.com/news/local/government-and-politics/e59f6588-a839-11e0-9e4b-001cc4c002e0.html#ixzz1Tme4c5jn
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