PACENET Income Eligibility Limit Increased

In December 2021, the Pennsylvania legislature passed and the Governor signed Act 94 of 2021, which raises the income limit to qualify for the PACENET pharmaceutical assistance program by $6,000 a year. Starting February 21, 2022, the income limits for the PACENET program will be as follows:

  • Single: $33,500/year (approximately $2,791/month)
  • Married: $41,500/year (approximately $3,458/month)
     

The PACE and PACENET programs helps eligible Pennsylvanians aged 65 and over with their prescription drug costs.  These programs are funded by the Pennsylvania Lottery and administered by the Pennsylvania Department of Aging.  With the new, higher income limits for PACENET, the expectation is that 100,000 more older adults will be able to enroll and receive assistance with their prescription drug costs. 

Because PACE/PACENET looks only at an applicant’s income does not consider resources, it is a good option for people who do not qualify for Medicare’s Extra Help program because of their resources.  For eligible enrollees in PACENET, a 30-day supply of a generic medication costs $8 and a brand name medication costs $15.

PACE/PACENET eligibility is determined based on your previous year’s income.  This means that people applying for PACE/PACENET in 2022 will have their applications reviewed based on their 2021 income.  The amount people pay for the Medicare Part B premium is not counted as part of their income.  People receiving full Medical Assistance benefits do not qualify for PACE/PACENET, but those who only receive help with the Medicare Part B premium through the Medicare Savings Program can qualify if they meet the program requirements. 

The Department of Aging reports that the applications of people who applied for PACE/PACENET in the past year and were found ineligible will automatically be reviewed for eligibility under the new income limits once they become effective.

People interested in applying or seeking more information can call the PACE hotline at 1-800-225-7223 or go to https://pacecares.magellanhealth.com/.  People can also call PA MEDI’s statewide helpline at 1-800-783-7067 to be connected with their local PA MEDI (formerly APPRISE) program for more information about PACE and PACENET, or for help applying.