Updates To Programs That Can Help People Access Health Care Services In Connecticut
Changes are coming to CT State programs that assist with medical expenses. The state of Connecticut faces a severe budget deficit and many changes are being made over the next few months to programs which will directly impact people with MS and their families.
We need your stories and examples of how these changes impact people with MS for our advocacy work to improve public policy and programs. If you have difficulty obtaining necessary medications, services or equipment as these changes become effective, let us know. E-mail programs@ctfightsMS.org or call 860.913.2550.
ConnPACE
The Connecticut Pharmaceutical Assistance Contract for the Elderly and the Disabled Program (ConnPACE) provides coverage for prescription drugs for low income elders and people with disabilities in Connecticut.
If disabled, you may be eligible to receive disability payment under the Social Security Disability Insurance (SSDI) Program or the Supplemental Security Income (SSI) Program. Participants pay a yearly enrollment fee plus lower co-pays for each prescription. For single people, the income limit for 2009 is $25,100. For couples, the income limit is $33,800.
If you think you may be eligible for ConnPACE:
1. Contact ConnPACE to complete an application and pay the registration fee.
Applications are available at www.connpace.com or by calling 1.800.423.5026.
*If you have Medicare and haven’t applied for ConnPACE, you must apply between Nov. 15 and Dec.31, 2009.
**If you have never received Medicare then you must apply for ConnPACE within 30 days of either turning age 65 or becoming eligible for SSDI/SSI.
2. Apply for the Medicare Savings Program
If you are eligible for Medicare, make sure that you sign up for the Medicare Savings Plan program which helps to pay for your Medicare Premiums using a special federal program. Medicare savings plans are also called QMB, SLIMB and QI programs.
Contact your regional office of the CT Department of Social Services (DSS) for assistance. Call the main office of DSS at 1.800.842.1508 or Infoline at 211.
3. Choose a Medicare Part D plan
Make sure you choose one of the approved options for ConnPACE. Call CHOICES for assistance at 1.800.994.9422 to speak with a counselor in your area.
If you are a current ConnPACE participant:
1. Enrollees must sign up between Nov. 15 and Dec. 31, 2009.
2. The annual enrollment fee is increasing from $30 to $45.
3. You must sign up for the Medicare Savings Plan program.
This helps to pay for your Medicare premiums using a special federal program. Medicare savings plans are also called QMB, SLIMB and QI programs.
Even if you have been denied in the past, you must reapply for the Medicare Savings Program because the income requirements and income disregards have been changed to help people on ConnPACE get this savings.
Contact your regional office of the CT Department of Social Services for assistance. Call the main office of DSS at 1.800.842.1508 or Infoline at 211.
4. Elimination of Coverage for Non-Formulary Drugs
The state has eliminated paying for medications that are not included in a ConnPACE participant’s Medicare Part D plan. As these changes are being implemented, there may be a process for appealing decisions.
Other Proposed Changes For State Funded Health Care Programs
- Expensive medications and dosing variations are now subject to prior authorization requirements. Work with your physicians and pharmacist to understand changes in the process and work to continue receiving necessary medications.
- The state is working on narrowing the definition of “medical necessity” over the next year. This may lead to denials of services, procedures, medications and equipment that can substantially improve life for individuals on any type of state-funded programs. This new definition of medical necessity may block access to certain procedures, medications and services.
- Coverage for dental care has been reduced and will require pre-authorization.
- Individuals on the state-funded home care program for people over age 65 will now have to pay 15% of the cost of their services.
- Many types of medical providers will see a reduction in their Medicaid reimbursement rates.
The National MS Society is working with other organizations in our community to educate policy makers about the severity of these cuts and on ways to maintain or preserve programs. If you are interested in getting involved, please contact Susan Raimondo at programs@ctfightsMS.org or 860.913.2550, ext. 229.