Senior Gold New Jersey Prescription Program

When PAAD's Income Limit Doesn't Quite Fit

Your parent earns slightly too much for PAAD — maybe they have a small pension on top of Social Security that pushes them over the $54,943 threshold. In many states, that would be the end of the conversation. New Jersey created Senior Gold for exactly this group.

Senior Gold is a state-funded prescription discount program that covers NJ residents whose income falls between the PAAD ceiling and a higher cap. It doesn't reduce drug costs as dramatically as PAAD, but after a member's qualifying out-of-pocket expenses exceed the program threshold, covered prescription copays become a flat $15 for the rest of the eligibility period.

2026 Income Limits

Like PAAD, Senior Gold has no asset test. Bank balances, investments, and home equity don't matter. Only annual income.

The eligibility requirements are identical to PAAD in every other respect: age 65 or older (or receiving SSDI if under 65), and living in New Jersey.

How the Copays Work

Senior Gold uses a two-part copay structure. For each prescription:

1. Your parent pays a $15 base copay
2. Of the remaining balance after Part D processes the claim, your parent pays 50% and Senior Gold pays 50%

A practical example: for a medication where Part D leaves a $65 copay, your parent pays $15 plus half of the remaining $50, totaling $40 out of pocket. Senior Gold covers the other $25.

The Out-of-Pocket Threshold

This is Senior Gold's most valuable feature. The threshold is:

• $2,000 for a single enrollee
• $3,000 for a married couple

Once qualifying out-of-pocket expenses exceed the threshold, every covered prescription for the rest of the eligibility period costs a flat $15 — no percentage share. Both the amounts your parent pays and what Senior Gold pays count toward reaching the threshold.

For seniors taking expensive specialty medications or multiple daily prescriptions, this lower flat copay can save thousands of dollars compared to standard Part D cost-sharing alone.

How to Apply

Senior Gold applications go through NJSave, the same portal used for PAAD and Medicare Savings Programs. The NJSave application automatically screens for both PAAD and Senior Gold — if income is too high for PAAD, the system evaluates Senior Gold eligibility without a separate filing.

Apply online, by paper (Form AP-2 mailed to PO Box 637, Trenton, NJ 08625), or by phone at 1-800-792-9745. The Division of Aging Services processes Senior Gold applications directly.

Unlike the Medicare Savings Programs, Senior Gold does not require bank statements. The key documents are proof of income (Social Security award letter, pension statements), proof of NJ residency, and a Medicare card showing Part D enrollment.

Part D Enrollment Is Required

Senior Gold enrollees must be enrolled in a Medicare Part D plan. Unlike PAAD, Senior Gold does not pay the monthly Part D premium — your parent is responsible for the plan premium directly. Choosing a low-premium or $0-premium benchmark plan keeps this cost manageable.

Renewals

Senior Gold cards are issued for one or two years. Renewal packets arrive about four months before expiration. Return the renewal form at least 45 days early to maintain uninterrupted coverage.

The New Jersey Medicare Savings Programs, Extra Help & PAAD/Senior Gold Guide covers both PAAD and Senior Gold in detail, including the eligibility worksheet and worked examples showing exactly what your parent would pay at the pharmacy under each program.

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