JEFFERSON CITY — Missouri offers a program to help seniors with the gap in coverage under the Medicare prescription drug benefit. But some advocates complain that thousands of seniors have endured months of expenses without receiving that help and other seniors don’t know it exists.
Years before the federal prescription drug program for the elderly and disabled became reality, Missouri offered a plan to help poor seniors with high prescription costs.
In 2005, the SenioRx program covered drug costs for more than 17,000 Missourians age 65 and older who had too much money to qualify for the government-run Medicaid program for the poor but not enough to afford private prescription coverage.
The program was revamped under legislation passed last year to simply fill in where the new federal benefit leaves off.
George Oestreich, Division of Medical Services deputy director, said the new program, called Missouri Rx, automatically brought in more than 158,000 people in January who were already signed up under the old state program or eligible for both Medicare and Medicaid.
An open enrollment period for others to sign up has been delayed by a couple of months while the agency tries to finalize agreements with drug companies to provide rebates on their products, which would provide more state money for the program.
Now, Oestreich said, the department plans to allow anyone meeting the criteria to enroll starting Nov. 1 for coverage to begin in January. To qualify, people must be eligible for Medicare, have signed up for the Medicare prescription drug plan and have income of no more than 200 percent of the federal poverty level, which means an individual can make no more than $19,600 a year.
An additional 60,000 Missourians could join the program, Oestreich estimated.
Under the federal Medicare prescription benefit, senior citizens pay a monthly premium — generally about $32 — plus the first $250 in annual prescription costs, while Medicare covers 75 percent of the next $2,000. There is no coverage for prescriptions costs of between $2,250 and $5,100. Medicare then covers 95 percent of amounts higher than $5,100.