New Jersey Prescription Plans
Title II Disability claimants must be on disability for 24 months before they are eligible for Medicare. Once a claimant is eligible for Medicare, he/she then has seven months to select a Medicare Part D drug plan. If the claimant fails to select a plan within the seven month window, he/she must then wait for the next open enrollment period. Open enrollment begins on November 15th of each year and ends on December 31st.
In the interim, or as an added cost saving measure, consumers can save significantly on their prescriptions by purchasing from chain stores like Target. With the cost of prescriptions consistently on the rise, it may be worth your while to check into a store discount program. Stores with discount programs include: Costco, Walgreens, Target, Walmart, and ShopRite. Here are some tips to keep in mind when considering purchasing from a discount store:
Costco: The Costco Member Prescription Program is open only to Costco members and their dependents that do not have coverage for any prescription drugs. You must be a Costco member to access Costco's pharmacy and its discounts. Members pay an annual fee to shop at Costco and that fee also entitles members to discounts on prescriptions from Costco's Preferred Drug List. You can find out more at www.envisionrx.com/costco/cmpp.aspx or call 1-800-806-0129.
Walgreens: Walgreens offers over 5,000 name brand and generic medications with 400 generics priced at $12 for a 90-day supply. No prior authorizations are required and you can sign up just by stopping by your local Walgreens. To find out more about Walgreens Prescription Savings Club, you can call 1-866-922-7312 or go to www.walgreens.com/pharmacy and click on "Walgreens Prescription Savings Club."
Target: Target has a $4 Generic Drug Program that allows participants to purchase generic drugs from an extensive list at $4 for a 30-day supply or $10 for a 90-day supply. Find out more by calling 1-877-RxTarget or visiting http://sites.target.com/site/en/health/page.jsp?contentId=PRD03-004033. Walmart: Walmart offers an Enhanced $4 Prescription Program that includes 350 generic medications at $10 for a 90-day supply. Additionally, Walmart offers women's health medicines discounts on a number of women's health drugs. For those expensive over-the-counter drugs, Walmart offers consumers 1,000 different drugs, like Zantac® and Claritin®, for only $4 - that saves you approximately 50% on commonly purchased non-prescription drugs. To find out more, call 1-800-331-0085 or go to www.walmartstores.com/HealthWellness/8247.aspx.
Other options:
If you qualify for Medicare, you should know that Medicare's prescription drug coverage offers the option of joining a government sponsored prescription plan. Enrollment begins November 15th and ends December 31st. If you think you may qualify, you should contact the Social Security Administration at www.socialsecurity.gov or call 1-800-633-4227.
AARP offers members a MedicareRx Plan with three options. To find out more, go to www.aarpmedicarerx.com or call 1-800-264-2403.
If your Title II disability benefits place you slightly over the SSI Title XVI benefits, you may still qualify for a Medicaid card through Medicaid/Medically Needy program which is administered by county welfare offices.
If you have HIV/AIDS, your county has a prescription plan under the Hyacinth Foundation. Check your county listings for the Hyacinth Foundation near you or visit www.hyacinth.org. Keep in mind that some drug companies will help subsidize your pharmacy needs for non-generic drugs. Be sure to research and make the most of your prescription (and non-prescription) purchases. There are money-saving options out there so take advantage of them.
Backlog Issues
Backlog is an ongoing issue in any government agency and Social Security is no exception. Processing times are affected by region and by other factors like increases in appeals and fluctuations in the economy. As of July 2008, the Newark/Hackensack hearing offices were ranked #74 in the nation with a backlog of over a year. Voorhees was ranked #82 with a slightly longer delay in processing time.
The bad news is that the waiting time for a hearing is long this year but processing times are improving every month. The Social Security Administration has recently undertaken a new strategic plan designed to improve efficiency. The plan's goals include elimination of the hearings backlog, improving the speed and quality of the disability process, increasing the number of staff that hear and process claims, screening hearing requests, and increasing the usage of video hearings. Hopefully, now that files are becoming paperless, the delay will continue to get shorter. Also there is a procedure called an "On the Record" review in which we can request a decision on a case without a hearing. We reserve this process for the cases which clearly should be proved without any complicated issues.
The process can be daunting and it may be helpful to employ an attorney to help you navigate the system. Please contact us if you feel you may need representation.
New Jersey Healthcare Plan Rankings
U.S. News & World Report recently reported the results of their annual review of health plans. The publication ranked the top 20 healthcare plans using data collected by the National Committee for Quality Assurance. Unfortunately, for the most part New Jersey's health care insurers did not make the grade. The most highly rated of the New Jersey companies was Cigna HealthCare of New Jersey (HMO/POS) which came in 75th in the survey. New Jersey's remaining providers ranked from 82nd down to 167th. At the top of U.S. News & World Report's "Honor Roll" was Harvard Pilgrim Health Care of Massachusetts and Maine.
The report separately ranked Medicare plans where New Jersey plans fared only slightly better with AmeriHealth of New Jersey coming in at number 43 and Aetna Health of Southern New Jersey at 46th on the list.
For answers to these and other issues please call us.
Sheryl Gandel Mazur, Esq.
Jacqueline Cleveland, Esq.
And Staff
