PINELLAS COUNTY – Since June 1, Medicare beneficiaries have been able to enroll in the Medicare-Approved Prescription Drug Discount Card. Whether to enroll is not an easy decision. This is the most complicated program Medicare has ever offered to beneficiaries, but there is help for beneficiaries in figuring out this program.
A beneficiary has to do some homework before making a decision whether to enroll. First, the beneficiary needs to make a list of all prescriptions, including the dosage, frequency and cost. Then, find out what card programs are available in the area. For each card program, learn which prescriptions are covered and the price of each using the card. Finally, make a decision whether to enroll in the card.
How much a beneficiary will save on prescriptions using a Medicare-approved drug discount card depends on the beneficiary’s situation. The discount card program may save some people a lot of money and others a little. Some beneficiaries are not eligible for the card, such as those beneficiaries who have Medicaid drug coverage. The program is voluntary – a Medicare beneficiary does not have to enroll in the card program, and some beneficiaries may decide that the card doesn’t give sufficient savings.
There are certain things a beneficiary must remember. A beneficiary can only have one Medicare-approved drug discount card at a time. A drug discount card company can change the covered drugs and the cost of the drugs at any time. There may be an annual premium of up to $30 for the card. For low-income beneficiaries ($12,569 for an individual for 2004) there is a $600 credit available for this year and next year toward the cost of prescription drugs.
The drug discount card is a stop-gap or transitional program that ends Dec. 31, 2005 (the new Medicare Part D starts Jan. 1, 2006). Once a beneficiary enrolls in a card, the beneficiary can change cards only between Nov. 15 and Dec. 31, 2004. After that the beneficiary keeps the card through 2005. Medicare does not actually offer the cards – instead, Medicare approves cards offered by companies.
Beneficiaries can get help by calling the Serving Health Insurance Needs of Elders (SHINE) program through the Department of Elder Affairs. For an appointment with a SHINE counselor, call 570-9696 or (800) 963-5337, who will spend up to an hour discussing a card’s options. A beneficiary can also call Medicare at (800) 633-4227, who also will discuss the process or go to the Medicare Web site www.medicare.gov to locate the list of discount drug cards offered, the prescriptions covered by each card and the costs for each drug.
Besides the Medicare-Approved Prescription Drug Discount Card, there are other ways for a beneficiary to save money. There are many other drug discount cards besides the Medicare-approved cards. Although a beneficiary can only have one Medicare-approved card, a beneficiary can have many other drug discount cards which may save more money (using one card per prescription).
Some pharmaceutical companies offer discount or free drugs for beneficiaries (usually low-income beneficiaries). The state of Florida also has an assistance program for low-income beneficiaries. A beneficiary may have a Medicare Supplemental Insurance Policy (Medigap policy) with prescription drug coverage. A SHINE counselor will review all of these options with the beneficiary and help calculate which will save the most money.
How much a beneficiary will save with a Medicare-Approved Prescription Drug Discount Card really depends on each individual situation. Low-income beneficiaries are likely to benefit the most from the card program. However, before a beneficiary can make a decision whether to enroll in the card program, the beneficiary needs to know all the options and the savings from each.
Rebecca C. Morgan is the Boston Asset Management faculty chair in elder law at Stetson University College of Law in Gulfport.