HOW IT WORKS
The
ConnPACE program, administered by the Connecticut Department of Social
Services, has served Connecticut's senior citizens and people with
disabilities since 1986. ConnPACE is a state-funded prescription drug
assistance program which covers most prescription medications, insulin, and
insulin syringes.
ConnPACE has established an annual open enrollment period for any new
applicants to the program. The ConnPACE open enrollment period coincides
with the Medicare Part D annual open enrollment period from November 15 to
December 31 of each year. This will be the only opportunity for new
applicants to be considered for the program. The only exception to the open
enrollment period is for an individual within 31 days of his/her 65th
birthday or becoming eligible for Social Security Disability or Supplemental
Security Income. Those individuals who were ConnPACE members prior to
October 1, 2009, will maintain their existing re-enrollment date. Again,
the new ConnPACE open enrollment period only applies to new applicants to
the program.
For
ConnPACE members enrolled in a Medicare Part D Prescription Drug Plan,
ConnPACE becomes secondary, providing certain wrap-around coverage.
ConnPACE will pay for prescription costs that exceed the $16.25 co-payment
for medications on the approved drug list of the individual’s Medicare Part
D Prescription Drug Plan (formulary drugs). |
ConnPACE will
also provide monthly premium assistance for ConnPACE members enrolled in a
Connecticut-approved ‘benchmark’ Medicare Part D Prescription Drug Plan.
For members enrolled in a non-benchmark plan on or after January 1, 2010,
ConnPACE will NOT provide premium assistance.
The
following applies only to ConnPACE members who are not eligible for
Medicare:
Effective October 1, 2009, the ConnPACE program is now subject to a
Preferred Drug List (PDL). The PDL will be a list of prescription products
determined to be successful, safe, and cost-effective by the state’s
Pharmaceutical and Therapeutics Committee. A drug on the PDL is considered
a "preferred" drug. A drug that is non-preferred will not be covered by
ConnPACE unless a Prior Authorization for that drug has been approved by the
Department's contractor, Electronic Data Systems. Preferred and
non-preferred status only applies to those medications that fall within the
drug classes listed on the PDL. Mental health and HIV drug classes are not
included on the PDL; therefore, they are not subject to preferred and
non-preferred status. All strengths and dosage forms of a preferred
medication are covered unless otherwise stated. The PDL applies only to
ConnPACE members who are NOT Medicare eligible.
Click here
for the current ConnPACE PDL. |