SUBJECT:
THE MISSOURI RX PLAN (MoRx) AND APPLICATION FORMS
DISCUSSION:
Section 208.782 RSMo, passed by the 93rd General Assembly, created the Missouri Rx Plan (MoRx), a state pharmacy assistance program administered by the Division of Medical Services. MoRx works in conjunction with the Medicare Prescription Drug Program (Medicare Part D) by helping to pay some of the costs not covered by Medicare Part D for qualifying elderly and disabled Medicare beneficiaries. Open enrollment for new members begins November 1, 2006.
MoRx Enrollment Process
The MoRx open enrollment period begins on November 1, 2006, and continues year round. All individuals receiving both Medicare and Medicaid are automatically enrolled in MoRx and do not need to apply. Medicare beneficiaries not receiving Medicaid benefits may apply to enroll in the MoRx plan beginning November 1, 2006. The MoRx plan benefits will begin on January 1, 2007, for new members. There is no cost or enrollment fee to join MoRx. Once the individual is enrolled in MoRx no annual re-enrollment is required.
To enroll in the MoRx Plan individuals must submit an application form. Applications are available by calling MoRx at 1-800-375-1406. In addition, application forms will be available at the following locations: Pharmacies, Area Agencies on Aging, County Health Departments, Family Support County Offices, and Public libraries.
A supply of application forms will be sent to each FSD county office. These forms are to be placed in an area that is easily viewable by clients. Eligibility specialists are to assist in providing information about the MoRx program and in completing application forms. FSD staff can contact MoRx at 1-800-375-1406 for additional application forms, application forms in Spanish, or questions regarding the MoRx plan. The application form includes a return address and informs the applicant that s/he will need to include proof of Missouri residency, a copy of his/her social security card, and a copy of his/her Medicare card with the completed application form.
MoRx Eligibility Requirements
Medicare beneficiaries must have income at or below 200% of the Federal Poverty Level (This is $19,600 per year for an individual and $26,400 for a couple.). No asset or resource limitations apply. MoRx members must be enrolled in a Medicare Part D Plan in order to receive the benefits of the MoRx Plan.
MoRx Benefits
MoRx pays 50% of the member's out of pocket expenses remaining after their Medicare Part D Prescription Drug Plan pays. This includes 50% of deductibles, co-pays, and one half of the gap. The MoRx Plan does not provide assistance with the Medicare Part D Plan premium. The MoRx benefit is not available for mail order prescription service through the Part D plan. MoRx covers a maximum of a 31-day supply per prescription fill per month. The MoRx benefit is not available for 90-day supply purchases.
NECESSARY ACTION:
- Review the memorandum with all appropriate staff.
- Display MoRx applications in an area viewable by clients.
- Assist in providing information about MoRx and in completing application forms.
- Contact 1-800-375-1406 for more applications, applications in Spanish, or questions regarding MoRx.
ER
ATTACHMENT:
MoRx Application Form 