Program Description
Missouri’s State Pharmacy Assistance Program is more commonly referred to as the Missouri Rx Plan or MORx. 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 plans (Medicare’s prescription drug program), 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.
As of 2022, MORx is only available for those who are receiving both Medicare and an MO HealthNet (Medicaid) benefit.
Did You Know? Relative to the state’s median income, Missouri has some of the most, if not the most, affordable assisted living in the nation.
Eligibility Guidelines
To be eligible for this program, seniors must meet the following criteria:
- Be a resident of Missouri.
- Be at least 65 years of age or designated as disabled by the Social Security Administration.
- Be enrolled in or willing to enroll in a Medicare Part D Plan.
- Be enrolled in or willing to enroll in a Medicaid (called MO HealthNet in Missouri) benefit.
Note that persons enrolled in or eligible for the Missouri Medicaid (MO HealthNet) prescription program cannot concurrently receive assistance under this program.
Benefits and Services
MORx will pay for 50% of participants’ out-of-pocket prescription costs (deductibles, copayments, and coverage gap) on prescriptions covered by a participant’s Medicare Part D Plan. MORx participants get coverage for Medicare-excluded drugs through MO HealthNet. Some drugs that are not covered by Medicare include vitamins, certain over-the-counter drugs, and limited cough and cold drugs.
Make note, this program does not assist in covering the cost of Medicare Part D Plan premiums. Nor does it have enrollment or application fees. However, some participants perceive an added cost since they are required to enroll in a Medicare Part D plan, which they might otherwise have chosen not to do. In addition, some participants have an annual Medicaid spend down, which they must meet in order for MORx benefits to kick in.
How to Apply / Learn More
In order to be eligible for this program, you must be a Medicaid participant, called MO HealthNet in Missouri. Residents of Missouri can apply for MO HealthNet online, by calling 855-373-9994, or by downloading and printing out an application and mailing it to Family Support Division, 615 E. 13th St., Kansas City, MO 64106.
Visit the MORx frequently asked questions webpage for more information, or contact MORx at 800-375-1406 with any questions. Once an applicant is enrolled in this program, there is no need to reapply.
The state of Illinois has two programs designed to provide financial assistance to the elderly to help them purchase their prescription drugs. Rx Basic is for individuals without Medicare insurance and the Rx Plus is designed for those on Medicare.
Rx Plus is known as a Medicare wraparound program which means the benefits wrap around those benefits provided by a Medicare Part D plan. When making a prescription purchase, Medicare Part D is the first payer and then this program contributes towards those costs the Part D plan does not cover.
