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Medicare and MediMed in Puerto Rico: Your Questions Answered

Cost savings for low-income Puerto Ricans

We are all aware that major advances in medicine and prescription drugs are keeping us healthier and living longer. However, the costs of these life-saving drugs are rising every year. The Medicare Modernization Act was signed into law in December 2003. This law is a good first step in addressing one of the most serious problems facing older adults: the high cost of prescription drugs.

While AARP understands that we are still a long way from achieving prescription medication at reasonable prices, we believe this law is an important step toward improving the quality of life and health in Puerto Rico as well as the mainland United States.

How will this law be implemented in Puerto Rico?
The implementation of this new law has begun and its full implementation has been divided in two phases. The first phase, which began in June of this year and will end December 31, 2005, offers residents of Puerto Rico two Medicare-approved discount card options and a special debit card for low-income Medicare beneficiaries, known as MediMed.

The reason for the short life of this phase is because this is a transitional program leading to the second phase, a permanent Medicare prescription drug benefit to be known as Part D, which will be in place by January 2006. (More information on the second phase will be in an upcoming issue.)

How do I participate in the first phase, which offers prescription drug discount cards?

From now until December 31, 2005, all Medicare beneficiaries can purchase a discount card for about $30. This card lets you buy prescription drugs at a 15 percent to 25 percent discount. Purchase of the card is entirely optional and no beneficiary will be required to buy it.

Where can I buy a discount card?
In Puerto Rico, the discount card may be purchased through RxSavings and Walgreens Health Initiatives. These two companies are the only ones that can exclusively carry the label authorized by Medicare and sell the discount card in Puerto Rico.

What is MediMed about?
The new Medicare law allocates $33.5 million for a special fund to be managed by the Puerto Rican government. Through this fund a prescription drug debit-card program was established, and the Puerto Rican government will distribute the funds via the MediMed card.

What is the MediMed card?
The MediMed card is for low-income Medicare beneficiaries not covered by Reforma, the Puerto Rican government’s health insurance plan, and not belonging to any other plan that covers prescription drug medication. This card is different from the Medicare-approved discount card. The MediMed card is a debit card. Each card has a credit equal to $150 per quarter and may only be used to buy prescription drugs. Any money not used at the end of each quarter cannot be used the following quarter.

Who is eligible for a MediMed card?
The Puerto Rican government estimates that about 60,000 Medicare beneficiaries are eligible for a MediMed card. To qualify for a MediMed card, your monthly income may not exceed $931 for an individual or $1,249 for a married couple. Your local Oficina del Programa de Asistencia Médica of the Puerto Rican Department of Health will determine your eligibility. To apply, you must present proof of income and proof of Medicare coverage (for example, your Medicare card). Also remember that to be eligible for the MediMed card, you cannot have any other prescription drug coverage by another plan.

However, if you have a MediMed card, you may still buy a Medicare discount card.

If you participate in the Reforma program or other private prescription drug plan, you are not eligible for the MediMed card. But you may purchase a Medicare discount card.

Here are the steps to follow to obtain your MediMed card:

  1. Visit your local Medicaid office (Oficina del Programa de Asistencia Médica) to apply for your MediMed card.
  2. Take the following documents with you:
       a. A valid ID (driver’s license, electoral card, etc.).
       b. A document showing that you are a Medicare beneficiary.
       c. A document showing your income.
  3. Fill out the card application form.
  4. Once you are notified that you have been approved, pick up your card at the Oficina del Programa de Asistencia Médica of the Department of Health.
  5. To ensure that you receive the allowable discount, always present your card when purchasing medication at participating pharmacies.

 

Remember…

  • Buying a Medicare discount card is optional.
  • MediMed card users may also buy and use a Medicare discount card.
  • Medicare beneficiaries who have discount cards with other drug companies may also buy the new Medicare discount card. Always compare the discounts each card offers before deciding which one to buy.
  • For information, visit Walgreens Health Initiatives online or call toll-free at 800-504-3769. RxSavings can be reached toll-free at 866-216-5777. Both offer service in Spanish. The cards cost between $20 to $30 a year.
  • For information on the Medicare discount card, visit the official Medicare website or call 800-633-4227; service is also available in Spanish.
  • When calling the above numbers, make sure to tell the operator that you need information specifically applicable to Puerto Rico. The law is implemented differently in Puerto Rico.
  • If you think you qualify for a MediMed card, apply now! For information on MediMed, you may visit Puerto Rico’s Department of Health website or call the Governor’s Office for Elderly Affairs toll-free at 877-725-4300; or not toll-free, 787-725-4300, or 787-833-2021.
  • Double-check all information you receive with the appropriate pharmacies and government offices. Don’t let the opportunity to benefit from these discounts pass you by!
  • Be well informed about the benefits of each card. Protect your pocketbook by researching the available discounts and buying the cards that offer the best discounts on the medications you purchase. You can compare the discounts offered by Medicare-approved cards online at the official Medicare website.

 

These links are provided for informational purposes only. AARP does not endorse, and has no control over, or responsibility for, the linked sites or the content, advertisements, materials, products, or services available on or throughout these sites.

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