Missourians set to lose Medicare benefits July 1

11 months 2 days 22 hours ago Thursday, June 22 2017 Jun 22, 2017 Thursday, June 22, 2017 6:59:00 PM CDT June 22, 2017 in News
By: Amanda Henderson, KOMU 8 Reporter

COLUMBIA – Some Missouri citizens will be affected by a change coming to the Missouri Rx program.

On July 1, those who have only Medicare Part D or Advantage coverage will no longer be eligible for benefits through Missouri Rx. The program will only continue to benefit those individuals with either Medicare or MO HealthNet assistance.

This could lead to a rise in costs for those who are set to lose the benefits.

“What Missouri Rx does is Missouri Rx pays 50 percent of a person’s [prescription] at the actual pharmacy for the Medicare-covered prescription,” Lead Trainer for the Missouri Claim Program Tracey Wetzel said.

The program is expiring, and neither the Missouri General Assembly nor the governor has sought to re-authorize it. Throughout Missouri, this will affect around 64,000 people. In Boone County it will affect about 800 individuals.

Care Connection for Aging Service has been helping a surge in clients who have found out they will be losing coverage. Care Connection works with CLAIM, which is the State Health Insurance Assistance Program, to provide help seeking options.

“It does not affect everyone with Missouri Rx. Those individuals that have Missouri HealthNet coverage or have coverage through a Medicare savings program, are not affected by this change. Their coverage continues,” Wetzel said.

There will be a special enrollment period for those who have Medicare Part D and are losing Missouri Rx. The Missouri Department of Social Services sent clients letters explaining the changes but were asked to save the letters to have proof they qualify for the special enrollment period eligibility, which will be valid for two months.

Though they are losing the 50 percent payment, they are not losing everything.

“The big thing we want people to understand is that they’re not losing their Medicare prescription drug coverage,” Wetzel said.

“So we are seeing a lot of people that actually qualify for extra help from Social Security Administration to help pay for their drugs, which will significantly reduce their cost,” Wetzel said.

Despite receiving several phone calls a day, no one can really promise that there will be a quick solution for those who are losing coverage.

“We can see if [those losing coverage] are eligible for other programs. But it is really not fair to say to these people that we can solve this problem for them,” Jean Leonatti said.

Missouri Rx members who are losing their coverage make anywhere between $1,528 - $1,805 by themselves per month. As a couple, that number could range from $2,428 - $2,050.

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