Despite Marketing Efforts, Enrollment ‘Lags’ in New Jersey’s Prescription Drug Assistance Program for Middle-Class Seniors

After six months of operation, New Jersey's Senior Gold program, a prescription drug plan for middle-class seniors, has not reached its enrollment estimates, the Bergen Record reports. Since its inception in June, Senior Gold has enrolled about 23,000 seniors, compared with an estimate of 100,000 eligible seniors. Under Senior Gold, participants pay the first $15 of each prescription and then evenly share the remainder of the cost with the state. The plan offers catastrophic coverage once an individual has paid $2,000 per year in out-of-pocket costs, although each medication purchase after reaching that amount still requires a $15 co-pay. Couples receive catastrophic coverage after they spend $3,000 per year. To qualify for coverage, seniors must earn no more than $29,238 for individuals and $33,589 for couples. Because of the program's "sagging enrollment," acting Gov. Donald DiFrancesco (R) froze $30 million of the $50 million budgeted this year for Senior Gold. Kathleen Mason, the assistant health commissioner, said the state has "aggressive[ly]" promoted Senior Gold through statewide presentations. In addition, the program's administrators mailed letters to 140,000 eligible seniors identified through a review of income tax returns. Mason added that many seniors have Medigap or other supplemental insurance and may not realize that Senior Gold coverage can be used along with other plans to reduce prescription drug costs.

PAAD Enrollment Up
While enrollment in Senior Gold is "lagging," the program's marketing efforts have increased enrollment in the state's Pharmaceutical Assistance to the Aged and Disabled program, which is designed for lower-income seniors. Senior Gold marketing "attracted" about 8,000 seniors, who were "steered" toward PAAD, which offers "more generous" benefits. PAAD is open to seniors and residents with disabilities who have annual incomes of up to $19,238 for individuals and $23,589 for couples. The 25-year-old program covers the total cost of prescriptions, after seniors contribute a $5 copayment. The "unexpected jump" in PAAD enrollment will cost the state about $13 million more than expected this fiscal year, the Record reports. Health department spokesperson David Jamieson said the state has not promoted PAAD "for years," except for notices mailed with utility bills (Parello, Bergen Record, 12/17).