PACE and PACENET offer
low-cost prescription assistance for older adults, age 65 and
older, who qualify. Members enrolled in either of these
programs may choose a SEP once per year, any time during
the year, to join a Medicare Advantage plan or Part-D plan
for the first time or to change to another Medicare
Advantage plan or Part-D plan. However, if a member is
automatically enrolled in a Part-D plan by their State
Pharmaceutical Assistance Program, they will not have this
SEP option.
Beginning January 1st, 2019, the
Commonwealth of Pennsylvania is paying the late
enrollment penalty (LEP) in full for members in
either of these programs; see additional info below:
PACE:
- The Commonwealth will pay
a maximum of $35.63 for a member’s Part-D premium
and full Part-D LEP for non-low-income subsidy
(LIS) individuals.
- Individuals that qualify
for LIS will receive a subsidy of no more than
$35.63 benchmark amount and no Part-D LEP.
PACENET:
- The Commonwealth will
pay full Part-D LEP only for non-LIS
individuals.
- The Commonwealth
will not pay towards any PACENET premiums in 2020.
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Special Enrollment Periods (SEP) permit
changes to a Medicare Advantage Plan or Medicare prescription
drug plan coverage outside of the regular enrollment periods
when certain life events occur. Common examples of these
events are:
- Relocation
- Loss of employer coverage
- Loss of dual eligibility status
- PACE/PACENET/LIS
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