NJ Expands Access To Prescription Drug Discount Programs

TRENTON, NJ — More New Jersey senior citizens and residents with disabilities are eligible for the state’s discount prescription drug programs thanks to a $10,000 increase in the income limits for the programs.

The change in the income limits, announced Jan. 6, expands access to the Pharmaceutical Assistance to the Aged and Disabled (PAAD) and the Senior Gold Prescription Discount drug assistance programs, benefitting more than 20,000 additional residents.

The PAAD program income limits are now $38,769 if single and $45,270 for a couple. The Senior Gold Prescription Discount program limits are now $48,769 if single and $55,270 if married. Assets are not an eligibility consideration for either program.

It is the largest one-time increase in the history of the programs, state officials said.

"Cost should not be a barrier to medicine," said Louise Rush, director of the state Department of Human Services Division of Aging Services. "By expanding the income eligibility to the PAAD and Senior Gold prescription assistance programs, we are opening these savings to more residents who need the help."

The change comes as prescription prices continue to rise significantly more than inflation. In 2020, prices for 260 commonly used medications increased 2.9 percent while the general rate of inflation was 1.3 percent, according to an AARP report.

"It’s unfair that drug prices keep rising, even for medications that have been on the market for decades," said Leigh Purvis, director of health care costs and access at AARP. That report found the total retail prescription drug costs for the typical older American who takes four to five prescription drugs per month would be $31,000 per year — more than the $29,650 average annual income for Medicare beneficiaries.

The cost of Victoza, a diabetes medication, increased 42 percent from 2015 to 2020, from $7,936 to $11,300 for a year's worth of the medicine, according to AARP, which has been tracking prescription prices since 2006. Lyrica, used to treat fibromyalgia, increased by 47 percent, from $5,827 a year to $8,562.

The increase in costs for basic needs has only added to the stress on residents’ budgets, and that can mean older residents and those with disabilities being faced with choosing between their medications and food or basic needs.

The PAAD and Senior Gold Prescription Discount drug assistance programs are available to residents 65 and older and those with disabilities. PAAD reduces prescriptions to $5 for covered generic drugs and $7 for covered name brands. Senior Gold cuts prices in half after a $15 copay for covered prescriptions.

"Few issues have a greater financial impact on New Jersey families than the ever-increasing cost of prescription drugs," Gov. Phil Murphy said in announcing the increased income limits. "Making New Jersey a more affordable place to call home means working to address the cost of prescription drug medicine. I am extremely proud of the progress we have made with this historic benefit increase that will expand benefits to thousands of New Jerseyans."

PAAD, created in 1975,was the first-in-the nation senior program, according to the National Conference of State Legislatures. New Jersey is one of 22 states with similar subsidy programs; 27 others have discount programs to assist with prescription costs.

Senior Gold started in 2001 using funds from New Jersey's share of the 1998 settlement between several states and five big tobacco companies over the health hazards associated with smoking, NJ Spotlight reported.

More than 138,000 New Jersey residents were enrolled in the two programs as of 2019, the NJ Spotlight report said.

Both programs are designed to work collaboratively with a Medicare Part D plan, so people must be enrolled in Medicare Part D. Part D serves as the primary payer and Senior Gold or PAAD as the secondary payer.

"We know when budgets are tight, individuals are faced with difficult decisions like stretching their medication or leaving prescriptions unfilled," said Sarah Adelman, acting commissioner of the New Jersey Department of Human Services. "This historic benefit increase will allow many older residents and individuals with disabilities to qualify for the first time for prescription savings."

Income limits for the Lifeline utility assistance program and the Hearing Aid Assistance to the Aged and Disabled (HAAAD) program have also increased by $10,000, as those programs are tied to PAAD.

Eligible older residents and individuals with disabilities are urged to apply now through the NJSave online application, download an application from the NJSave webpage, or ask for a paper application by calling 1-800-792-9745. Online and paper applications are available in English and Spanish.

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