Confusion Grows Over Medicare Prescription Drug Cards
With more than 70 drug card options, no guarantees that the card you select will save you money, and no incentives for drug companies to lower their prices for senior citizens, it’s no wonder that there is a lot of confusion and worry about the new Medicare prescription drug cards that went into effect in May 2004. These concerns are justified according to the results of a recent study by Families USA. “The overwhelming majority of seniors will receive no help this or next year from skyrocketing drug prices, and their medicines will be much more unaffordable,” according to Families USA’s Executive Director Ron Pollack. “For those who get discounts, potential savings will be negated by large increases in base prices…Congress and the President could have provided real drug price relief for all seniors had they allowed Medicare to bargain for lower prices, like the Department of Veterans Affairs does for veterans…”
To address the many questions arising from this new program, the Alliance for Retired Americans developed the following basic information about the new program:
Medicare Drug Discount Cards
More Choices for Seniors?
Rhetoric
“These are the kinds of health care options we give to members of Congress … what’s good for members of Congress is also good for seniors.” [Bush speech, 12/8/03]
Reality
The new benefit is worth much less than the standard drug benefit available to members of Congress.
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Background: Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173), a Medicare prescription drug benefit will begin January 1, 2006. Until then, beneficiaries can purchase Medicare-approved drug discount cards, which may or may not offer you savings on your prescription drugs. Bottom line: seniors better shop around.
Basics: Medicare-endorsed private companies will offer drug discount cards for an annual fee of up to $30. Savings are estimated to range between 10-15 percent. Although savings are not guaranteed, those with incomes below 135 percent of the federal poverty level ($12,569 for an individual, $16,862 for a couple in 2004) will get the cards for free and also receive a $600 credit; they will still have co-pays of 5-10 percent per prescription.
Who is eligible for the card?
Everyone who is entitled to Medicare Part A and/or enrolled in Part B. Medicaid beneficiaries, however, are not eligible.
How can I compare the various cards to determine which is best for me?
The Medicare website at www.medicare.gov or telephone assistance at 1-800-MEDICARE will provide information on all Medicare-approved discount cards. Seniors and their families should be aware that this will take some research and a lot of patience. Chances are you will not find one card that offers discounts on all your medications, so choose a plan that offers the greatest discounts on your most expensive drugs. Keep in mind that once you have made a decision, you are locked into one card for each year, but the drugs covered by the card and the negotiated prices for discounted drugs may change as frequently as every week.
How can I calculate savings?
Unfortunately, the new law does not set any rules about base drug prices. In fact, drug prices will likely change because pharmaceutical companies can raise prices at any time.
Can I get more than one card and can I use the card at any pharmacy?
No, on both counts. Cards will vary:
• Offering different discounts on different drugs;
• They will be honored only at certain pharmacies in certain locations;
• Some may offer better discounts for people with low incomes.
Most likely you will receive material from dozens of companies offering cards. Older Americans should beware of anyone who calls or shows up at their door offering to sell them Medicare prescription drug discount cards. Medicare drug cards will not be sold via any telemarketer or door-to-door salesman and will be stamped with an official logo indicating it is “MEDICARE APPROVED.”
How will the card affect my state drug assistance program?
Each state will have to determine how to coordinate with the drug cards.
Should I even sign up for the card?
If you have drug coverage from another source (other than state pharmaceutical assistance) or are already getting discounts of 10-25 percent through other means, the card probably will not help you. If you are a low-income senior and eligible for the $600 subsidy, it would be worthwhile to apply.
Where can I find more information?
Additional resources on the Medicare Rx Discount Cards:
Official Medicare Site www.medicare.gov
or call 1-800-MEDICARE
State Health Insurance Counseling and Assistance Programs (SHIPs) http://www.medicare.gov/contacts/Related/Ships.asp
Administration on Aging www.aoa.gov
Medicare Rights Center www.medicarerights.org
Families USA www.familiesusa.org
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