Medicare
Prescription Drug Cards Available
HHS/CMS News Release
May 3, 2004
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HHS Has Detailed Resources to Help Beneficiaries Make Informed Choices
HHS Secretary Tommy G. Thompson announced today that
seniors and people with disabilities who receive Medicare can now begin to
compare and choose the Medicare-approved drug discount card that best fits
their needs in providing savings on their prescription medicines. The new
cards are expected to offer Medicare beneficiaries discounts on their
prescription drugs of
between 10 and 25 percent. Low-income beneficiaries may also receive a
credit of up to $600 each year in 2004 and 2005 to help pay for
their prescriptions.
Beginning today, private organizations can begin marketing their
Medicare-approved discount cards to people with Medicare and beneficiaries
are now able to compare cards
and enroll in the one they choose. Medicare is providing a new Price
Comparison Web site at www.Medicare.gov, on which industry drug prices are
being posted for the first
time.
Secretary Thompson said the drug discount cards are an important new way
for seniors to save money on their prescriptions, and he encouraged people
with Medicare to shop
and compare the prices offered by various cards. Secretary Thompson said
competition between card sponsors will work to drive down prices even
further, particularly in
the first couple weeks of the program -- providing an even greater
opportunity for seniors to save.
"The power to save on prescription drugs is now in hands of seniors and
people with disabilities," Secretary Thompson said. "This is a first.
Industry is competing on-
line for the business of millions of Medicare beneficiaries and those
beneficiaries have now pooled their purchasing power to demand the best
price.
"Seniors should compare prices and choose the card that's best for them,"
Secretary Thompson said. "Help in comparing cards is only a phone call
away to 1-800-MEDICARE,
where a customer service representative will send beneficiaries a
personalized comparison of cards available to them for the drugs they
take."
Secretary Thompson particularly urged low-income seniors who may qualify
for the $600 credit in addition to the discounts to participate in the
drug card program. The
discount card program is providing unprecedented assistance to low-income
seniors and persons with disabilities to pay for their medicines, he said.
"Those in greatest need will receive the most help from the drug discount
card program," Secretary Thompson said. "Seniors and their caregivers
should pursue whether they
are eligible for the $600 credit and avail themselves of this helpful new
benefit."
Low-income Medicare beneficiaries may qualify for the $1,200 credit over
the 18-month life of the discount card program to help pay for the
prescription drugs if their
income in 2004 is no more than $12,569 if single or no more than $16,862
if married.
In addition, the Centers for Medicare & Medicaid Services (CMS) recently
announced that low-income Medicare beneficiaries enrolled in state
pharmacy assistance programs
that provide discounts on prescriptions drugs may, at the state's option,
be automatically enrolled for the $600 credit on a Medicare-approved drug
discount card. States
that have the authority to act as an "authorized representative" of a
beneficiary (as defined by state law) will be permitted to enroll
beneficiaries in drug discount
cards on the beneficiary's behalf. This step will make it easier for
low-income beneficiaries in states with pharmacy assistance programs to
get $600 in additional help.
To make it even easier to sign up for a discount drug card as well as the
$600 credit, CMS has established a standard enrollment form that all card
sponsors will have to
accept. This form will also be used by State Health Insurance Assistance
Programs (SHIPs), and other partners and organizations that assist
beneficiaries with their
health care decisions. While Medicare is providing comparisons and
assistance with enrollment, the beneficiaries must enroll directly with
the card sponsor they choose.
All Medicare beneficiaries, except those who have outpatient drug coverage
through Medicaid, are eligible to enroll in a Medicare-approved drug
discount card program
starting today. Beneficiaries who enroll by the end of May will be fully
eligible for the discounts and financial assistance beginning in June. The
card sponsors may
charge an annual enrollment fee of no more than $30, though many cards
have lower fees and some have no fee. There is no enrollment fee on any
card for people who qualify
for the $600 credit.
To date, CMS have approved 40 national cards available to all eligible
beneficiaries, 33 regional cards available. This includes a national Long
Term Care card available
for those in nursing homes and a regional card available for the
Territories. A small number of additional card applications are still
being reviewed, and the number of
cards that meet all Medicare requirements is expected to increase. The Web
site will post the prices of more than 60,000 drug products at nearly
50,000 pharmacies.
"It's important for beneficiaries and their family members to take the
time they need to look into all the cards that are available," said CMS
Administrator Mark B.
McClellan, M.D., Ph.D. "But beneficiaries who qualify for the $600 credit
and free enrollment should try to sign up this month, so that they can get
the maximum
assistance with their drug costs."
Secretary Thompson said the opportunity for beneficiaries to band together
to get lower negotiated prices, along with an unprecedented, large-scale
public reporting of
prescription drug prices, will put pressure on card sponsors to reduce
prices so that beneficiaries will get the best savings on their medicines.
HHS is offering tools
and personalized assistance to help seniors and other people with Medicare
to compare cards and choose the one that provides them with the best
savings.
Beneficiaries can compare the prices of drugs offered by the drug cards at
www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This
information will help
them compare the discounted prices negotiated by the card sponsors, as
well as the enrollment fees, and other discount card features. They can
also compare the prices of
drugs being charged at their local pharmacies and find out the cards the
pharmacies honor. The card sponsors provide the pricing and pharmacy
information to CMS and that
information is being updated weekly.
Customer service representatives at 1-800-MEDICARE can answer questions
about the program, help callers compare the drug cards on price and
network pharmacies, and
provide additional information for low-income beneficiaries on
prescription drug assistance programs sponsored by their state and by drug
manufacturers. The customer
service representatives will mail the personalized results of the
comparison to callers.
"If you tell us your zip code and your medicines, we will sort through
information on about 60,000 drug products and nearly 50,000 pharmacies to
find the best prices for
your needs," Dr. McClellan said. "And if you want to focus on cards that
include particular pharmacies, or particular sponsors, or low or no fees,
we can do that too.
The next business day after you contact us, we'll mail you an
individualized booklet that gives you detailed information on the cards
that meet your preferences and
provide the best prices, on other sources of personal savings like
discounted generic drugs, and on how to enroll."
In addition to 1-800-MEDICARE and www.medicare.gov, HHS is reaching out to
seniors and others who receive Medicare to inform them of the benefits of
the Medicare-approved
drug discount cards, including:
· -- Issuing a detailed "Guide to Choosing a Medicare-Approved Drug
Discount Card" that explains the program, including eligibility and
enrollment information, and
provides step-by-step guidance for comparing discount cards and choosing
one. The booklet is now available at www.medicare.gov and through
1-800-MEDICARE. · --
Increasing funding for and working with SHIPs to provide one-on-one
counseling and distribute educational material to people with Medicare to
help them make choices.
SHIP counselors are located at senior centers and other locations
accessible to beneficiaries and their families to help them better
understand Medicare and assist them
with their particular concerns and choices of drug discount cards. · --
Continuing the 1-800-MEDICARE advertising campaign with a national
television ad campaign of
$18 million to inform people with Medicare about the discount cards and
place an emphasis on explaining the $600 credit. The broader campaign also
includes print and
Internet advertising in both English and Spanish. · -- Mailing a
shorter, overview publication directly to every Medicare household.
"We are making it as easy as possible for Medicare beneficiaries to get
the information they will need to make a decision that best fits their own
prescription drug
needs," Secretary Thompson said.
Medicare-approved drug discount cards must offer discounts on prescription
drugs for all of their Medicare enrollees. At least some of these savings
must come from
manufacturer rebates. Card sponsors also must publish prices for the
prescription drugs their cards will cover, provide access to an extensive
retail pharmacy network,
operate call centers and have a process to respond to beneficiary
concerns. Card sponsors may add drugs or lower prices at any time, but can
only increase the negotiated
price for covered drugs if there is a legitimate change in the sponsor's
costs, such as changes in the discounts, rebates or other price
concessions received from a drug
maker or pharmacy. Medicare will also collect and track consumer
complaints about Medicare-approved cards.
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