Across the country, the rising costs of prescription drugs have become a significant financial burden for many individuals and families, even more so for lower-income earners. However, if you’re a resident of Pennsylvania, 65 and above, and looking for ways to alleviate the financial strain of prescription drugs, the PACE and PACENET programs can help.
PACE
PACE stands for the Pharmaceutical Assistance Contract for the Elderly (PACE) program and is designed to help Pennsylvania residents aged 65 and older.
Who Is Eligible for PACE?
You must be 65 and above
Have been a Pennsylvania resident for at least 90 days
You must not be receiving Medicaid prescription benefits
Have an income of less than $14,500 if you are an individual
Have an income of less than $17,700 if you are a married couple
Note that income qualification is based on the previous year’s salary and includes taxable and non-taxable sources.
PACE Benefits
You only have to pay at most $6.00 for a generic drug and $9.00 for brand name drug
If you have both Part D and PACE:
Help with paying Part D premiums up to the regional benchmark amount.
No coverage gaps, as you can use PACE as a secondary prescription coverage
For prescription medications not on the Part D plan's formulary, PACE will provide coverage.
Copayments of $2 for generics and $5 for brands if you have extra-help subsidy
Cost of PACE
Enrollment in the PACE program is free.
PACENET
The PACE Needs Enhancement Tier (PACENET) program is designed for individuals who do not meet the income requirements of PACE but are still facing financial challenges with purchasing their medications.
Who Is Eligible for PACENET?
You must be 65 and above
Have been a Pennsylvania resident for at least 90 days
You must not be receiving Medicaid prescription benefits
Have an income of between $14,500 and $33,500 as a single person
Have a combined total income of between $17,700 and $41,500 as a married couple
As with PACE, income qualification is based on the previous year’s salary and includes taxable and non-taxable sources.
PACENET Benefits
You won’t pay more than $8.00 for a generic drug and $15.00 for a brand-name drug.
As a PACENET Cardholder with Medicare Part D:
You won’t pay the monthly deductible but will pay the plan's Part D premium directly to the pharmacy.
No coverage gaps, as you can use PACENET as secondary prescription coverage
For prescription medications not on the Part D plan's formulary, PACENET will provide coverage.
Cost of PACENET
If you meet the requirements, you’ll pay a monthly premium of $41.08 (2023), which is waived if you enroll in a Medicare Part D plan.
How to Apply for PACE and PACENET
To get an application form, visit your local area agency on aging or the legislator's office. Alternatively, access and complete the online application through the Pennsylvania Department of Aging's website.
You can also print an application and send it to PACE/PACENET, PO Box 8806, Harrisburg, PA 17105-8806 or as an email to papace@magellanhealth.com. If you prefer to fax, the number is 1-888-656-0372.
Get Extra Help With PACE or PACENET Today
If you need help navigating PACE or PACENET, we’ll gladly help for FREE. We are a leading independent Medicare insurance agency working with low-income seniors to get help with their prescription drugs and other health needs. Contact us today.