Nj paad program qualifications

To find out more about Senior Gold's interaction with the Medicare prescription drug benefit program. Click Here. Governor Sheila Oliver. DHS Home. Division of Aging Services Home. Adult Day Care. Alzheimer's Adult Day Services. A Matter of Balance. Area Agencies on Aging. Community Choice. Falls Prevention.

Staying Healthy. Getting Help at Home. Staying Safe. NJ Save. Provider Resources. Contact Us. PAAD will pay the monthly premium for certain standard basic Part D plans with a monthly premium at or below the regional benchmark.

These plans will cover medically necessary prescription medications under Medicare Part D. If a beneficiary self-enrolls in an enhanced plan at or below the regional benchmark premium amount, PAAD will pay the premium as long as the plan agrees to follow all the billing requirements. However, if a Medicare Part D plan does not pay for a medication because the drug is not on its formulary, PAAD beneficiaries will have to switch to a drug on their Part D plan's formulary, or their doctor will have to request an exception due to medical necessity directly to their Part D plan.

Medicare Advantage participants must add a prescription benefit to their coverage, and PAAD will contribute up to the regional benchmark amount towards the prescription portion of their total premium.

Additional Program Information PAAD provides coverage for prescribed legend drugs, insulin and insulin supplies, and needled and syringes for injectable medicines used for the treatment of multiple sclerosis. PAAD does not pay for diabetic testing supplies e. If PAAD beneficiaries have health insurance coverage, such as Medicare Part B that pays for diabetic testing supplies a pharmacy must bill that insurance plan. PAAD will not pay for them.

Only drugs approved by the Food and Drug Administration are covered. Drugs purchased outside the State of New Jersey are not covered, nor is any pharmaceutical product whose manufacturer has not agreed to provide rebates to the State of New Jersey. If you have health insurance or retirement benefits that provide prescription coverage equal to or better than PAAD, or if you are receiving Medicaid, you would NOT be eligible. The experts at New Jersey Medicare Brokers can work with you over the phone or video chat.

Let them get you up to speed on changing programs like PAAD and others. Eligibility requirements are as follows: You must be a New Jersey resident. You are aged 65 or older, or you are between the ages of 18 and 64 and are receiving Social Security disability benefits. You must be enrolled in Medicare Part D. You cannot be on Medicaid, which has its own programs to help eligible recipients.