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Loss of Drug Program Spells Hardships

Will end of Illinois Cares Rx save money or cost the state more?

AARP Bulletin State News IL: Medicaid

Barbara LaConte, of Berwyn, pays three times as much for her eye drops since losing Illinois Cares Rx coverage, and now has to pay her monthly Medicare Part D premium of $34.50 a month as well. — Jon Lowenstein/NOOR

Older Illinois residents and their advocates are warily monitoring the impact of losing Illinois Cares Rx, a state program that paid part of prescription drug costs for 168,000 older and disabled people until it ended two months ago.

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The program's coverage was reduced in September 2011 and was eliminated altogether on June 30 with only a few weeks' notice. It was one of many programs that were cut by the legislature to plug a massive state budget deficit. Ending the program will save the treasury about $73 million annually.

Illinois Cares Rx paid Medicare Part D premiums and required participants to pay a copayment of $5 to $20 depending on the type of drug.

Participants began to directly feel the program's loss during the past two months when refilling prescriptions and being charged new, higher out-of-pocket prices.

"They'll go to the drug store, put their Illinois Cares Rx card on the counter and be told it won't work any longer," said Michael O'Donnell, executive director of the Bloomington-based East Central Illinois Area Agency on Aging.

"Some may just walk away from the pharmacy because they can't afford to pay the higher cost," O'Donnell said. "Others may pay the cost of the medication and then not buy something else they need, like food."

Facing higher costs

About 143,000 older residents were using Illinois Cares Rx to supplement their Medicare benefits, including Part D prescription drug coverage, according to the Illinois Department of Healthcare and Family Services. The remaining 25,000 who used the program were disabled people under 65.

Barbara LaConte, 76, of Berwyn, a suburb just west of Chicago, knows what's in store for those who lost Illinois Cares Rx coverage in June. She was removed from the program in last September's cutbacks and saw her prescription prices rise on her next trip to the pharmacy.

"Illinois Cares Rx covered my Medicare Part D [prescription drug] premium, so that's $34.50 a month I pay now," she said. She uses daily eye drops that her doctor says she needs to prevent blindness. The drops — formerly subsidized by Medicare Part D and Illinois Cares Rx — used to cost her $12.60 a month but now cost $39. Prices also increased for her blood pressure medications, said LaConte, a retired caterer and switchboard operator.

Next: What to do if you need help paying for prescription drugs. »

The end of Illinois Cares Rx could fail to save the state any money, said David Vinkler, AARP Illinois associate director. That would happen if older people who have lost access to their medications are forced to get medical care in hospital emergency rooms or in nursing homes. That cost would be much greater than the cost of subsidizing prescriptions and would be paid by taxpayers through Medicaid.

Easy targets

"Unfortunately, people receiving help with prescription expenses make easy targets," Vinkler said. "But does cutting those programs really save money? At this point, we don't think so."

Tina Saenz, an advocate at Solutions for Care, which helps older people obtain health care, housekeeping, legal services, home-delivered meals and other services in Chicago's western suburbs, helped one couple in their 70s apply for Illinois Cares Rx to pay for transplant follow-up medications, cancer treatment drugs, anticoagulants and other medications.

"The wife called recently and asked me to put her in touch with food pantries because they can't afford groceries any more," Saenz said. Their plight will only worsen as their prescription copays rise.

"There was no planning for a transition. Last year they cut [Illinois Cares Rx] in half on Sept. 1, but they gave us July and August to prepare," said John Coburn, senior policy attorney at Health & Disability Advocates of Chicago. Social service agencies thus had time to match beneficiaries to other programs, like Medicare Extra Help.

"This year there wasn't a lot of discussion," Coburn said. "They just got rid of it."

If you need help paying for prescription drugs, here is what you can do:

Medicare Extra Help — If you meet certain income and resource limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage.

Change Medicare Part D plan — You may find a plan that has lower premium costs or pays more for the specific drugs you need.

Prescription discount cards — Some pharmaceutical companies provide discounts for needy drug users. Contact your drug company to see whether you qualify.

Joseph Sjostrom is a freelance writer living in Oak Park, Ill.

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