The new Medicare law that was signed into law in December 2003 makes major changes to the nation's health insurance program for people age 65+ and some persons with disabilities. The most important part of the law is a new benefit to help people in Medicare with their prescription drug costs.
This assistance will go into effect in two stages. The first stage begins in May 2004 when you can sign up for a discount card to help with some drug costs. This is a temporary program that phases out when the second stage of assistance, a Medicare drug benefit, goes into effect on January 1, 2006. Once this begins, the discount cards will no longer be used.
In the meantime, starting in June 2004, discount cards with a Medicare-approved seal will save you about 10-15 % on your total prescription drug costs. Medicare will contract with private companies to offer these cards. The cost for a card will be no more than $30. This card is optional — you do not have to get a discount card if you don't want one.
However, if you decide to get a Medicare-approved discount card from a private company, you may pay less for your prescription drugs than you do now. Discounts will vary by card, and each plan will be slightly different. For example, some cards can only be used at certain pharmacies.
With many different cards available, and different discounts offered for different drugs on each card, how do you decide which card is the right one for you?
Choosing a Card
Start by making a list of the medicines you currently take, and include how much you pay each month for each prescription drug. Then, as you learn more about the different Medicare-approved discount drug cards that are available in your area, find out which cards offer the best discounts on the drugs you need. The card that offers the greatest discounts on the medicines you take is the right card for you.
Here are some important facts for you to consider:
- You can only get one Medicare discount drug card at a time.
- If you already have a different discount card, you can keep that card. You can also get a Medicare discount card. Use whichever one gives you the best deal.
- If you are in a Medicare+Choice plan, your plan may decide to offer a Medicare discount drug card. If it does, you can only choose that card. If your Medicare+Choice plan does not offer a discount drug card, you can choose any available Medicare discount drug card.
- If you are in a state Medicaid program with drug coverage, you will not be able to get the discount card.
- If you have drug coverage through an employer or former employer, you may not need the discount card.
- If you have a Medigap plan with drug coverage, you may get lower prices using the card. The card should not affect your drug coverage.
Special Help For People With Low Incomes
If you have a low income, you can get additional help. If your income is less than about $12,569 a year for one person, or $16,862 for a married couple, you may get up to $600 to help pay for prescription drugs in 2004 and again in 2005. You will not have to pay a fee for your discount card.
You will have to pay a low copay (5%-10%) each time you use the card while it still has a balance on it. If you use up the $600, the card can still be used for discounts.
If your drugs are already covered by Medicaid, you can not get the discount card. If you have drug coverage from an employer or the federal government, you cannot get the special low income features of the discount card.
The Bottom Line
Medicare-approved discount drug cards may be able to save you money on the medicines you need. Each card is different, and will provide different discounts on different drugs.
It's important to figure out which discount card will provide the most savings for you. Before choosing your Medicare-approved discount drug card, shop around to see which card best meets your needs.
For More Information
Medicare will give you more information as the benefits start. Visit the Medicare Web site or call toll-free 1-800-MEDICARE (1-800-633-4227 or TTY 877-486-2408). If you prefer to get help in person, there are counseling programs that can provide direct assistance.
