Health Care Issues

Medicare Discount Drug Cards

Retirees who are Medicare-eligible may find the new Medicare-approved drug discount card program very attractive, compared to their current drug coverage program. The Centers for Medicare & Medicaid Services have published a pretty straightforward guide to choosing a Medicare-approved drug discount card, which is available at www.medicare.gov. This 33-page official government booklet answers these basic questions: What are these cards? Who can get a card? How do they work? How does one choose the best card? Below is a recap of the highlights of the program.

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug, Improvement and Modernization Act. Within this act is the legislation that defines the future of prescription drug coverage for Medicare beneficiaries. There's an actual drug benefit that will be available January 1, 2006. It will take much time and effort to design and develop the regulations that will be used to implement this drug benefit for beneficiaries. Because of the planned delay, legislators provided some drug coverage/assistance more immediately through Medicare discount drug cards.

On March 25, HHS Secretary Tommy Thompson announced the approval of 28 private sponsors to provide seniors and people with disabilities savings on their prescription drugs beginning June 1. With the new cards, Medicare beneficiaries will receive discounts on prescription drugs, and low-income beneficiaries may receive an additional $600 to pay for their prescriptions in both 2004 and 2005.

All Medicare beneficiaries, except those who already receive outpatient drugs through Medicaid, will be able to enroll in one discount card program starting in May. The discounts will take effect beginning June 1. The card may charge an annual enrollment fee of up to $30. There's no enrollment fee for the low-income beneficiaries who qualify for the $600 credit. Discounts, covered drugs, and pharmacy networks vary by card sponsor.

Thirty cards will be offered nationwide to all eligible Medicare beneficiaries. There are an additional two cards offered locally. The cards will be promoted and offered by the individual card sponsors. Approved cards must offer discounts on prescription drugs for all Medicare beneficiaries enrolled in their program. Card sponsors must publish prices for the prescription drugs their cards will cover, provide access to an extensive retail pharmacy network, operate call centers, and have a process to respond to beneficiary concerns. Enrollment fees will vary by card.

All of the approved cards will provide a $600 annual credit to eligible low-income Medicare beneficiaries. Individuals whose income is less than $12,569 each year, or married couples whose income is less than $16,862, may qualify for this additional help. Medicare will cover the cost of the enrollment fee for these low-income card holders. The Social Security Administration will mail a separate letter to Medicare beneficiaries with lower incomes who are likely to be eligible for the $600 credit.

Starting in late April, beneficiaries can compare the prices and drugs offered by a sponsor at the Web site or by calling 1-800-MEDICARE. This information will help them compare discounted prices negotiated by card sponsors, as well as the enrollment fees and other card program features. People who are Medicare-eligible can enroll in one of these discount cards as early as May 3. Enrolling in a Medicare-approved drug discount card is voluntary; if you choose to enroll, you can use the discount card as early as June 1. IBI