In Illinois, there are a number of eligibility benefit
programs for low-income (and not so low) older adults. I will list the more popular and helpful
ones and if you have any questions or want to apply, contact your local senior
center or Area Agency on Agency for more information. Your state probably
has similar programs.
For Illinois, the Circuit Breaker/Senior Care
program has changed dramatically. It is now called IL
Cares Rx, which no longer covers a person's prescription
medications but provides wrap-around benefits for prescription coverage by 6
Part D plans. Two of them have the $275 deductible so we are not
recommending choosing them. There is IL Cares Rx Basic which was regular Circuit Breaker
and IL Cares Plus which was Senior Care. For 2008, both cover the premiums,
deductible (only for the Plus coverage) and provide
for co-pays of $2.25, $5.60 and $15 up to $2,510. A person
then picks up an additional 20% plus the co-pay. The state
of Illinois is
working with four companies and six plans. The current plans for 2008 will
also be available in 2009: United
Healthcare's AARP MedicareRx Preferred Plan, United Healthcare's Rx Basic Plan and Well
Care's Signature Plan. Three new plans have been added and they are:
First Health Part D-Premier, Humana PDP Standard and Silverscript. Humana
PDP Standard and Silverscript both have $275 deductibles.
If an IL
resident had Circuit Breaker or SeniorCare in 2008, that coverage will be
extended through 2009. They also
should have returned the 7-page form sent out from the Social Security
Administration. If you did not
receive such a form or threw it out, please contact either
your local senior center, Area Agency on Aging, Senior
Health Insurance Program (S.H.I.P.) counselor. If you have not yet filed
for 2008, contact your local Senior Center, Area Agency on Aging or S.H.I.P.
agency to have them help you file on-line.
One point that has not been well
advertised is that if you apply for Circuit Breaker/IL Cares Rx, you must also
send in a form to Social Security to apply for LIS (Low Income Subsidy) or
"extra help" as the Feds like to call it. Illinois requires that before
you will get the state help. When Social Security gets your form, it will
generate a letter that will tell you whether or not you receive Federal
financial help. If you qualify, great. If not, don't panic as Social
Security will kick your information over to the state and you will then receive
state help under the new program IL CaresRX Basic and Plus (which is the new
name for what used to be Circuit Breaker/Senior Care).
The Federal income limits are well
below what Illinois requires. Also, while the Federal assistance has an
asset limit, Illinois does not have an asset limitation. YOU MUST APPLY
FOR THE FEDERAL HELP IF YOU APPLY FOR CIRCUIT BREAKER, EVEN IF YOU KNOW YOU
DO NOT QUALIFY. In that case, you are denied and need to keep the
denial letter.
The way we
are helping our clients at the Senior Center and something you may want to do is
to check out the
www.medicare.gov web site and use the tool shown to
check out the formularies and compare the plans. You
will need to go past the list that is generated and look at
each plan individually as it is in the individual plans that
the drugs that are not in the formularies or that are
restricted are identified. At the side of each page,
you can click on the button and see exactly what the
restrictions are. We
are having our clients bring in their medication lists,
the dosages and what pharmacy they use and we will look up
that information for them. You might want to check
with your local senior center or social service center and
see if you can get that type of help from them. We can only guide people but the bottom line
is everyone will have to make their own decision.
WARNING: BEWARE OF THE
SCAM ARTISTS. They know this is very confusing so they are jumping in to
try and fleece seniors. Don't give out personal information on the phone
and don't enroll in any plan over the phone unless you make the call to the
company. Don't sign up with anyone going
door-to-door. Legitimate companies will not solicit
that way and it is against the law. If you have any questions about whether you
should sign up with a plan, don't -- give yourself time to
check it out further.
Circuit Breaker
(which was replaced with IL CaresRX Basic starting 1/1/2006) – Many times people get confused
because there is a tax program by the same name and for information on that,
contact your local tax assessor’s office.
The Circuit Breaker program I am referring to is the one that has 3
parts: cash grant,
discounted price on license
plates (and in Illinois that can be a real savings) and now
IL Cares Rx which will help with wrapping around the insurance plans that
coordinate with the state
for prescription
medications.
The requirement of
age 65 or permanently disabled remains the same. The
income limit
for 2008 is $22,218 for 1 person and
$29,240 for 2 people for the Circuit Break Property Tax Grant/License Plate
Discount. Once again the state of Illinois has changed the rules.
The new eligibility incomes for Illinois Cares Rx are as follows:
Illinois Cares Rx Basic -
$24,808 for a household of one
$32,916 for a household of two
$41,023 for a household of three
Illinois Cares Rx Plus -
$23,225 for a household of one
$31,264 for a household of two
Eligibility income is still
based on the
previous year’s income. The limit is
now $2,510 before the 20% kicks in. Each prescription will cost either
$2.25, $5.60 or $15.00. The list
of health conditions for IL Cares Rx Basic includes approved medications for
Arthritis, High Blood Pressure, Diabetes, Heart Conditions,
Osteoporosis, Cancers, Alzheimer’s
Disease, Lung Diseases and Smoking-related Diseases, Glaucoma,
and Parkinson’s Disease.
REMEMBER --
YOU STILL HAVE TO APPLY EVERY YEAR!!!
For more details, contact your local senior
center or social service provider that handles IL Cares Rx applications or has
the LIS applications.
Li-Heap (Low Income-Heating and Energy Assistance
Program or more commonly known as heating/cooling or energy assistance) is
administrated by CEDA (Community & Economic Development Association). Various agencies and Township
offices act as
sites where people can apply for this type of assistance. The person has to have a low-income and have
the electric or gas (or other heat provider) bill in their name. The income requirements change every
year. Usually the program starts in
September or October and runs as long as the money lasts. Check with your local Senior Center or CEDA office for a site
near you and the income requirements at that time. You will need to produce proof of income, a recent utility bill
or bills and proof of social security. Depending upon the family situation, other
documentation might be required.
www.benefitscheckup.org www.iltax.org
