Medicare Counseling
Available Services
Aging is becoming increasingly complex and living in a fast-paced society is not easy.
Through Berks Encore's APPRISE program, trained staff and volunteers for assistance with their insurance-related needs. Issues handled through this program include:
- Health insurance counseling
- Medicare
- HMOs
- Supplemental Insurance
- Medical Assistance
- Long-Term Care Insurance
- Produce Vouchers
- Rent and Property Tax Rebates
- PACE (Prescription Assistance)
- LIHEAP (Fuel Assistance)
- Free Notary Service
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Medicare Qualifications
To qualify for Medicare, a person needs to be 65 years of age or disabled for 25 months. There is no age limit for persons with End Stage Renal disease or with ALS.
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Schedule an Appointment
To schedule an appointment with a Berks Encore counselor, please contact one of Berks Encore's Senior Centers or send an email to APPRISE@BerksEncore.org. Appointments can be made at any center.
When you come for your appointment, it is important to bring as much information with you as possible so Berks Encore's counselors can find the best option for your specific circumstances. Click here to download a Medicare Counseling Document Checklist, which provides a listing of what items to bring to the appointment.
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PACEplus Can Help Pay for Prescriptions
PACE will help reduce the cost of your prescription medications. You may even qualify for reduced copays under Medicare Part D. You can be enrolled in PACE and other prescription plans. PACE will work together with Medicare Part D and Retiree prescription coverage.
You are eligible to apply if:
- You are 65 years of age or older. You are not eligible if you are under the age of 65 and disabled.
- You have been a resident of Pennsylvania for at least 90 consecutive days.
- You are not eligible for prescription benefits under Medicaid.
- PACE and PACENET are the two programs in the PACE plus program.
The income guidelines for PACE are:
- If you are single and your total income for last year was less than $14,500, or you are married and your combined income for last year was less than $17,000.
- You may be eligible for prescription benefits that have no more than a $6 copayment for generic drugs and $9 copayment for brand name drugs. PACE will pay your Medicare Part D premium for you.
- If you are single and your total income for last year was between $14,500 and $23,500 or you are married and your combined income for last year was between $17,700 and $31,500 you may be eligible for prescription benefits that have no more than an $8 copayment for generic drugs and a $15 copayment for brand name drugs. You pay all of your expenses at the pharmacy.
PACENET members not enrolled in a Part D plan will pay a nominal cumulative premium amount each month at the pharmacy. If this is the case, Berks Encore's Director of Information and Referral, Carolyn Krebs, encourages you to consider enrolling in a Medicare Part D plan.
PACE plus counts income NOT your assets. Income includes gross Social Security and SSI, RR Retirement, pensions, salary, taxable amount of annuities and IRAs, unemployment, lottery winnings and workers' compensation.
You can apply for PACE plus at any time of the year by calling 1-800-225-7223 or on line at PaceCares.fhsc.com. Berks Encore offers application assistance. Please call (610) 374-3195, x208.
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New Medicare Benefits
2011 ushered in several new Medicare benefits for older adults, including:
- A 50% discount on the price of brand-name prescription drugs for Medicare beneficiaries who enter the Part D donut hole or coverage gap.
- Free preventive screenings, including mammograms, colorectal cancer screenings, bone mass measurement and nutritional counseling.
- One free wellness visit each year for Medicare beneficiaries. You must request this.
This year will also see the creation of the new Center for Medicare and Medicaid Innovation. The center's mission is to help slow the rapid rise of health care costs and foster innovation in both caring for patients and processing payments and claims.
For more information about Medicare, please call (610) 374-3195 and schedule an appointment with one of Berks Encore's counselors.
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