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Pharmaceutical Assistance for the Aged & Disabled (PAAD) / Senior Gold
About
The Pharmaceutical Assistance to the Aged and Disabled program helps eligible New Jersey residents pay for prescription drugs, insulin, insulin needles, and syringes and needles for injectable medicines used for the treatment of multiple sclerosis. 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.
Qualifications
A PAAD beneficiary:
- Must have an annual gross income for 2022 of less than $38,769 if single or less than $45,270 if married
- Must be a New Jersey state resident
- Must be 65 years of age or older, or at least 18 years of age and receiving Social Security Title II Disability benefits
- Must enroll in a Medicare Part D Prescription Drug Plan
- State and/or federal governments will pay Medicare Part D premiums for certain standard basic Medicare Part D plans with a monthly premium at or below the regional benchmark. In addition, the State of New Jersey will pay Medicare Part D premium for certain standard basic Medicare Part D plans or enhanced Part D plans with monthly premiums up to $20 over the regional benchmark that have no deductibles. Medicare Advantage(MA) participants must add a prescription benefit to their coverage, and PAAD will contribute up to the regional benchmark amount towards the prescription portion of the total premium for New Jersey plans unless the MA plan is paid for by a former employer or union
Benefits
The PAAD co-payment will be $5 for each PAAD-covered generic drug prescription and $7 for each PAAD-covered brand-name drug prescription. PAAD beneficiaries may pay less for generic drugs if their Medicare prescription drug plan charges them less than the $5 PAAD copayment for generics.
About
Senior Gold Prescription Discount Program (Senior Gold) is a State-funded prescription program with a different co-payment structure and income eligibility guidelines than those of PAAD.
Qualifications
You are eligible for Senior Gold if you meet the following requirements:
- A New Jersey resident
- 65 years of age or older or 18 years of age or older and receiving Social Security Title II Disability benefits
- Annual income for 2022 is between $38,769 and $48,769 if you are single or between $45,270 and $55,270 if you are married
All Medicare-eligible Senior Gold beneficiaries are also required to enroll in a Medicare Part D Prescription Drug Plan of their choice. They will be responsible for paying the monthly premium directly to the Medicare Part D plan. They also will be responsible for paying any late enrollment penalty imposed by Medicare for each month they were eligible to enroll in Medicare Part D but did not enroll.
Benefits
Members pay a co-payment of $15 plus 50% of the remaining cost of each Senior Gold covered prescription. Once members reach annual out-of-pocket expenses exceeding $2,000 for single persons or $3,000 for married couples, they pay only a flat $15 co-payment per prescription for the balance of that eligibility period.