GAPS Coverage Enrollment Deadline Approaching
South Carolina seniors have until May 15 to enroll in one of 11 private prescription drug plans offering the new GAPS benefit administered by the SC Department of Health and Human Services.
GAPS (Gap Assistance Pharmacy Program for Seniors) helps qualifying seniors with drug expenditures between $2,250 and $5,100. Under the new Medicare Part D drug benefits that took effect January 1, seniors could otherwise be fully responsible for drug costs within the range of the so-called “doughnut hole.” SC GAPS helps fill the coverage gap by paying 95 percent of those drug costs.
“The GAPS benefit can provide much needed relief for some seniors faced with costly prescription drug bills,” said DHHS Director Robert M. Kerr. “I’d encourage all seniors, especially those who depend on expensive medications, to learn as much as possible about their drug plan benefits before the May 15 enrollment deadline. Remember, if you want to take advantage of the GAPS benefit, you must be enrolled in a participating drug plan.”
To qualify for GAPS, seniors must have incomes at or below 200 percent of the federal poverty level ($19,596 for individuals; $26,400 for a couple) AND be enrolled in a participating prescription drug plan (see below). GAPS was signed into law by Gov. Mark Sanford in February and replaces the former SILVERxCARD prescription drug program.
Seniors already enrolled in a drug plan also can switch to a different plan without penalty if they do so before May 15. To find out more about GAPS, call 1-888-549-0820 or visit DHHS online: www.dhhs.state.sc.us.
Please Note: Seniors with incomes below 150 percent of poverty may qualify for Extra Help, a separate program run by the Social Security Administration that covers prescription drugs costs between $2,250 and $5,100. Seniors who qualify for Extra Help do not need GAPS. Please check with the Social Security Office before applying for GAPS coverage. Call 1-800-772-1213 or visit Social Security online at: www.socialsecurity.gov
PARTICIPATING PROVIDERS
BlueCross BlueShield of SC: MedBlue Rx 1-800-930-2836
BlueCross BlueShield of SC: MedBlue Rx Plus; 1-800-930-2836
Community Care Rx: Community Care Rx Basic; 1-866-684-5353
Community Care Rx: Community Care Rx Choice; 1-866-684-5353
Community Care Rx: Community Care Rx Gold; 1-866-684-5353
First Health Life and Insurance Company: First Health Premier; 1-800-588-3322
InStil Health Insurance Company: InStil Rx; 1-877-446-7845
InStil Health Insurance Company: InStil Rx Plus; 1-877-446-7845
WellCare: WellCare Signature ; 1-888-423-5252
WellCare: WellCare Complete; 1-888-423-5252
WellCare: WellCare Premier; 1-888-423-5252