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A summary of the Medicare approved drug discount card and transitional assistance program
BACKGROUND
The Medicare Approved Drug Discount Card and Transitional Assistance Program is part of The Medicare Modernization Act of 2003, enacted into law on December 8, 2003. The purpose is to provide a voluntary program to help reduce prescription drug costs for people on Medicare. The drug discount cards will be effective from June 2004 until January 1, 2006 when the new Medicare Drug Benefit, part D will begin.
What Is It?
The Medicare-approved drug discount card will offer between 10%-20% discount off of the cash price of prescription drugs. It will probably benefit those individuals on Medicare who do not already participate in a prescription drug discount program. The card includes prescription medications as well as syringes and medical supplies for insulin injections. There will be a $30 annual fee for the card.
Who Is Eligible To Purchase a Medicare Approved Drug Discount Card?
Persons who are entitled to or enrolled in Medicare Part A or Part B, AND NOT receiving outpatient prescription drug benefits through Medicaid or Medicaid waivers, AND NOT already enrolled with a Medicare approved drug card sponsor.
When Will It Be Available?
Price comparisons for medications offered by the various cards will be available online beginning April 29, 2004 at www.medicare.gov, or by telephone at: 1-800-medicare.
Enrollment for the prescription drug cards will begin on May 3, 2004. You can purchase the card anytime after that date.
The prescription drug discount program begins June 1, 2004.
What Is The $600 Credit?
If your income in 2004 is less than $12,569 for an individual or $16,862 for a married couple you can receive $600 credit with the discount card towards the price of medications in 2004, up to $600 credit in 2005, and you will not have to pay the annual card fee. There is no asset test.
You will be responsible for 5%-10% co-pay (depending upon your income) for the medications received with the $600 credit.
In order to qualify, you cannot be receiving outpatient prescription drug coverage from any other sources such as Medicaid, Tricare, Federal Employee Health Benefit Plans, or group health insurance, EXCEPT, voluntary Medicare Part C MEDIGAP plans.
There is a separate low-income assistance card application that you will submit when you apply for the discount card.
How Do I Know Which Card, If Any, Is Best For Me?
There will be at least 2 cards available in every area. Different cards may be available through different pharmacies. The cards might not cover the same medications, and they might charge different prices. You will need to compare the different cards available in your area to see which one covers your medications, and which will give you the best prices. You may need to compare this against any other drug discount cards that might be available to you to determine which is best for you. Medicare will have a website available to compare Medicare approved discount drug cards after April 29th, or you can call 1-800-medicare.
You have between June and December to sign up for the discount card. During the year card sponsors may change which medications they cover on their card. You can only have one card, and once you select it, you cannot change until the open enrollment period between November 15 and December 31, 2004.
Further Information
Telephone: 1-800-MEDICARE. Or 1-800-633-4227.
Internet: Medicare website: www.medicare.gov
There are many drug discount cards available, besides the Medicare-approved drug discount cards. Before giving any personal information, or spending money on a card, it is important to be sure that it is a legitimate discount card that will save you money. If you suspect that a card is fraudulent, you can contact the Arkansas Senior Medicare/Medicaid Fraud Patrol at 1-866-726-2916, your local Area Agency on Aging office, or your local sheriff.
Medicare Rights, a private organization, lists other discount drug programs on their website.
http://www.medicarerights.org/
Where Can I Get Help?
Area Agency on Aging Case Managers.
Call 1-800-medicare or go to the Medicare website www.medicare.gov.
Your pharmacist can also help you with information on which discount cards they will offer, and which medications are available on each card.
This is intended as a brief summary of data from the official Medicare website, www.medicare.gov as of March 30, 2004, a teleconference training by the Centers for Medicare and Medicaid Services Outreach Team Region VI on March 10, 2004, and a report by the Henry J. Kaiser Family Foundation, December 10, 2003.
