MO HealthNet Division - Missouri Rx Plan

Description

MoRx provides prescription drug assistance by coordinating benefits with Medicare's (Part D) Prescription Drug Program. MoRx works with all Medicare Part D plans. MoRx pays for 50% of your out-of-pocket costs on medications that are covered by your Medicare Part D plan. This means you will save 50% on your deductible, 50% on your co-pays, including during the coverage gap and beyond. MoRx does not pay for the Medicare Part D plan's monthly premium. In addition to your Part D plan and MoRx benefits, you may be eligible for Extra Help with prescription costs from the Social Security Administration.

Hours

M-F 8am-5pm

Required Documents

Copy of your Medicare Health Insurance card, copy of your SS card. Do not send originals.

Eligibility

Income guidelines; Enrolled in a Medicare Part D plan; Covers medications on the Medicare Part D plan's drug formulary, as well as any drug covered by a member's Medicare Part D plan will also be covered by MoRx. Dual eligible members will have coverage for Medicare-excluded drugs. Cannot be used for mail order pharmacies.

Fees

None

Intake Procedure

Call or go to website to download application. Enrollment is open year-round. Once enrolled, you never need to re-apply.

Languages

Spanish

Service Area

Missouri

Geography Served

Special Notes/Funding

MORx is only available for those who are dually eligible for Medicaid and Medicare.

Description

This program assists low income seniors with the cost of their medications by paying up to 50% of their co-payment, deductible, and coverage gap amounts. The MORx Program is intended to supplement Medicare Part D (Medicare’s prescription drug program) plans, not to replace them. When an enrolled individual makes a medication purchase, Medicare Part D is the "first payer" and MORx is the "second payer," meaning the Missouri Rx Plan will only pay after Medicare Part D has paid their portion.

Hours

No set hours

Required Documents

In order to be eligible for this program, one must be a Medicaid participant.

Eligibility

Be a Missouri resident and intend to remain a resident. Be at least 65 years of age or designated as disabled by Social Security. Be enrolled in or willing to enroll in a Medicare Part D Plan. Be enrolled in or willing to enroll in a Medicaid or a Medicaid spend down program. Have monthly income below the limit. As of 2019, a single individual must have a monthly income below $1,805 ($21,660 / year) and a married couple must have a monthly income under $2,428 ($29,140 / year).

Fees

None

Intake Procedure

If one is not currently on Medicaid, one needs to apply. Visit the Missouri Department of Social Services Rx Plan webpage for more information or to apply for the program.

Languages

NA

Service Area

Missouri

Geography Served