New Medicare drug discount cards: Worth the effort?
º For some people, yes
>Some low-income Medicare recipients can get $600 toward any prescription drugs in 2004 and another $600 in 2005 by obtaining one of the new Medicare drug discount cards. The number of Californians eligible is relatively small, but if all the following apply to you, it’s definitely worth it to sign up:

  • You have Medicare – or should have it and sign up for it now.

  • Your current "adjusted gross income" (all your income, with a few exceptions, such as IRA or a 401(k) contributions) is no more than $12,569 a year for one person, $16,862 for a married couple. It doesn’t matter if your income rises later.

  • You are not a Medi-Cal recipient. (If your income is below the limits stated above, you are probably eligible for full Medi-Cal unless you own too much non-exempt property, such as savings or investments. Property is not a factor for the drug card benefit, however. Therefore, the typical profile of a California senior eligible for the $600 is someone with low income but too much property for Medi-Cal.)

  • You do not have some other health insurance plan through an employer or the government that covers prescription drugs. (Individual membership in an HMO or ownership of a Medi-gap policy does not make you ineligible. Health coverage as a veteran may or may not – this is one of several matters about the new program that are still not clear.)
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    º For some others, maybe
    >If you are not eligible for the $600 benefit program, a card may still be worthwhile:

  • If you are now paying for your own prescription drugs, spending a lot on them and have no better alternative. (See the section on alternatives, next page.)

  • If you compare the available cards and find one that will provide the drugs you need at lower cost.

    • º How to find a card that will help

  • If you receive your Medicare coverage through an HMO, you may not buy any other cards if your HMO offers one.

  • Otherwise, if you’re good at using the Internet, you can find all the information you need at www.medicare.gov. You can complete an application form on line, print, sign and mail it in to one of the drug card sponsors. If you need help, a number of service agencies offer it. Among them is the Senior Legal Hotline. See the end of this fact sheet for numbers, hours, how to contact us by e-mail, etc. Another source of help is your local HICAP office. To connect with it, call (800) 434-0222.

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    º More important facts:

  • The cards can cost up to $30, but some are less or free. Take that into account when you compare the different cards’ drug prices.

  • The cards are all free for those eligible for the $600 assistance. But there is a co-payment with each drug purchase – 5 percent or 10 percent, depending on income.

  • Different cards cover different drugs – and the sponsors can add or drop drugs whenever they wish. They can also change the prices, so today’s discount can become tomorrow’s bad deal.

  • Once you obtain a card, you can change to a different one only during the last six weeks of 2004 – unless you move to another state, enter or leave a nursing home or drop an HMO plan.

  • As of now, the discount card program is scheduled to expire at the end of 2005, when a different Medicare prescription drug plan is supposed to start. But the subject remains highly controversial. Many changes are possible by then.
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    º Watch out for scams!

    As with almost anything these days, crooks are out to make a  quick buck off your hopes and all the confusion with the drug card program.

  • If someone calls or comes to your door offering a Medicare drug card, it’s a scam. The real card companies are allowed to send you mail, however.

  • If the card doesn’t contain a Medicare seal of approval, it’s not part of the Medicare program. (Of course a scam card could forge the seal, so watch out.)

  • You can check the Medicare web site or call the Senior Legal Hotline to find out whether a card being offered to you is Medicare approved.

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    >To report a suspected scam, call the U.S. Inspector General: (800) 447-8477.

    º Some other alternatives

    1. You may be able to get medicines free or for very little through public health clinics in your area. Inquire locally to see whether you are eligible for care at such clinics.

    2. Your doctor may be able to give you some free samples he or she receives. Ask.

    3. Ask your doctor to prescribe generic drugs if possible; they usually cost a lot less.

    4. Try large discount stores that have pharmacies. Their prices are often a lot lower.

    5. There are other legitimate drug discount card programs for low-income seniors, offered by membership organizations or pharmaceutical companies before Medicare launched its plan. For some people they may be better. And some drug companies provide specific drugs for free or very low cost to needy patients. Methods vary: you may have to apply through your doctor. For more information on these programs, see www.rxassist.org – or call the Senior Legal Hotline.

    6. Creative consumers have discovered various other ways to obtain the medicines they need at prices they can afford – across borders or on line, for instance. Check with your doctor first to be sure you’re getting the right drug. To ask whether a source is legal or legitimate, call the Senior Legal Hotline.

    If you are over 60 in California, you can get free advice by phone from the Senior Legal Hotline regarding your questions about this or any other legal issue. Call (916) 551-2140 in Sacramento or (800) 222-1753 toll-free in California, Mon.-Fri. 9 to 12 and 1 to 4, until 7 p.m. on Thursdays. Or submit your question by e-mail from our web site, www.seniorlegalhotline.org