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Medicare Approved Drug Discount Card Program...

Many of you have probably received information from CMS (Centers for Medicare and Medicaid Services) regarding the new drug discount care programs. This information can be very confusing, please feel free to discuss the options with your Social Worker as they can provide guidance. You can also visit the www.medicare,gov website on the internet. The following are some basic rules for the program.

Step 1: Know the basics: there are two options:
A. Medicare approved drug discount card offered to any Medicare (Part A and Part B) eligible person.
B. A $600 credit to pay for prescriptions, this is based on income: Single person limit is $12,560 per year and Married limit is $16,862 per year.
IMPORTANT NOTES:
Persons eligible for Medicaid are not eligible for either option.
If you are enrolled in EPIC, you must decide between using EPIC or the discount drug care, you can't use both.
If you are enrolled in EPIC, and qualify for the $600 credit, you can use both programs.
C. Enrollment starts May 2004, cards can be used as early as June 2004 with programs lasting until 12/31/2005.
D. People with Medicare need to choose discount cards with a Medicare approved seal on them, which are offered by private companies. Cost for enrolling varies by card, but can be no more than $30 per year. If eligible, the $600 credit program is free.
E. If you are in a Medicare managed plan (soon to be called Medicare Advantage Plan), call them for guidance as your choices may be limited.
F. The discount card can save 10-25% of certain drugs

Step 2: Get personal: Complete a personal information sheet (This is not an enrollment form) to assist with decision-making for choosing a discount drug card.

Step 3: Find card options: If you have access to a computer, go to: www.medicare.gov and click on: "Prescription Drug and Other Assistance Programs". Use the information from your personal information sheet to answer questions and learn about the drug discount cards. If you don't have access to a computer, call 1-800-633-4227.

Step 4: Compare cards:
Look for the Medicare-approved seal, keep in mind a person can have only one Medicare-approved discount card.
If you need multiple drugs, check total savings and savings by drug. Sometimes the best card won't discount every drug you might need, but could provide bigger discounts on your most expensive drugs.
If you are loyal to a particular pharmacy, look for a card that includes the pharmacy.
If you have addresses in more than one state or travel for six months out of the year, look for a card with a national service area.

Step 5: Enroll in a card: Once you determine the best card, you will need to fill out an enrollment form. Enrollment forms for Medicare-approved drug discount cards are available from the private company that offers the card.
If you apply for the card and the $600 credit, you will need to mail or fax a copy of the enrollment form with a signature, some plans are able to enroll people over the telephone.
In 2006, a prescription drug benefit will be started and will work like this:
You will choose a prescription drug plan and pay a premium of about $35 per month.
You will pay the first $250.
Medicare then will pay 75% of costs between $250 and $2,250 in drug spending. You will pay only 25% of these costs.
You will pay 100% of the drug costs above $2,250 until you reach $3600 in out-of-pocket spending.
Medicare will pay about 95% of the costs after you have spent $3600.