ElderWeb

After years of debate a new Medicare prescription drug card program will be available starting in 2006. For the period from May of 2004 to December of 2005, an interim program will be available -- Medicare prescription drug discount cards. Medicare participants will need to decide which, if any, they want to select. Several programs at the American Society on Aging / National Council on Aging Joint Annual Convention in San Francisco explained the options, and the difficulties, participants can anticipate.

The cards will charge the participant an annual fee of up to $30 for a card that will entitle him or her to get a discount on prescription drugs. Low-income participants can have the enrollment fee waived and get a credit of $600 toward their out-of-pocket costs under the program. Each person is limited to ONE approved card, and once selected, the choice cannot be changed during the calendar year. This means everyone will need to carefully decide what to do in May (for their 2004 choice) and then again when they are given an opportunity to make a choice for the year 2005. Further confusing things, seniors will be getting offers for unapproved cards and may not realize they have chosen a card that is not approved.

Several resources have been developed to help seniors make choices (see the end of this article for links to those resources.) Because this decision cannot be changed, it will be important to carefully research the options before making a choice.

Some things to be aware of include:

Make sure the chosen card is "Medicare Approved" by looking for the official symbol. There are already stories of fraudulent marketing by companies selling cards that are not approved.

Use the tools below to be sure that the card will cover all the drugs you routinely take. NOT ALL CARDS WILL COVER ALL DRUGS!!

Make sure the network is convenient to you. Some cards may require you to use pharmacies that are not nearby.

Be sure to investigate this opportunity if you are low income or have very high drug costs. It is not clear how beneficial the cards will be to middle income people with moderate drug costs or other drug coverage.

You do not have to rush into a decision. There will be no penalty for waiting to enroll until you are sure what you want to do. This means it may make sense for people who won't get any immediate benefit from the card to avoid signing up at this time. Then, if you later encounter health problems and need the card to cover new prescriptions, you will be able to look for a card that provides coverage for the drugs you need.

Be aware that the card issuers can change the list of drugs that they cover after you have signed up for the card. You cannot change to a different card if that happens. One weakness of the program is that you will have no recourse if the drug you need is dropped or if you later find you need a new drug which is not covered. Panels at the ASA/NCOA convention recommended that you avoid cards with very low fees because they may be more likely to change their drug formularies (the list of drugs they cover) if their costs exceed their expectations.

Panelists also suggested looking hard at the card sponsors to make sure you are dealing with the most reputable ones.

Don't be rushed into making a decision. Take time to review all your options first.