Senior Gold Prescription Discount program - Helps pay for prescription drugs

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The Senior Gold Prescription Discount 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. The Senior Gold card works together with Medicare Part D Prescription Drug Plans. Senior Gold can reduce out-of-pocket expenses associated with participation in Medicare Part D.

  • Members receive assistance for prescribed legend drugs, insulin and insulin supplies.
  • Senior Gold does not pay for diabetic testing supplies (e.g., test strips and lancets). If Senior Gold beneficiaries have health insurance coverage, such as Medicare Part B that pays for diabetic testing supplies, a pharmacy must bill that insurance plan. Senior Gold will not pay for them.
  • Members pay a copayment of $15 plus 50% of the remaining cost of each Senior Gold covered drug.
  • 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 copayment per prescription for the balance of that eligibility period;
  • A Senior Gold beneficiary must be a New Jersey resident;
  • A Senior Gold beneficiary must be 65 years of age or older, or at least 18 years of age and receiving Social
  • Security Disability benefits;
  • A Senior Gold beneficiary must have annual income for 2021 between $28,769 and $38,769 if single or between $35,270 and $45,270 if married.
  • All Medicare-eligible Senior Gold beneficiaries must participate in Medicare Part D. Senior Gold beneficiaries must pay the monthly premium directly to the Medicare Part D plan of their choice. They also are 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.
  • Senior Gold benefits help to make Medicare prescription drug coverage more affordable by reducing any other out of-pocket costs associated with that coverage, such as deductibles, co-insurance, and the coverage gap known as the "donut hole."

Please contact the Sussex County Division of Senior Services

SHIP (State Health Insurance Assistance Program) office for more information at 973-579-0555, ext. 1223.


 

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