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Medicare Drug Discount Card

NOTE: This topic is provided for archival information only. The interim Medicare Drug Discount Card Program it describes is being phased out effective December 31, 2005. Effective January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage, will have access to prescription drug coverage through the new Medicare Part D Prescription Drug Coverage program.

You can use your Medicare-approved drug discount card until May 15, 2006, or until you join a Medicare prescription drug plan, whichever is first. Once you have a Medicare prescription drug plan, you can't use your Medicare-approved drug discount card. You will get coverage for prescription drugs through the Medicare prescription drug plan instead of saving with the discount card.

On December 8, 2003, the President signed into law the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. This landmark legislation provides seniors and people living with disabilities with a prescription drug benefit for the first time. All Medicare beneficiaries, except those who already have Medicaid outpatient drug coverage, will be able to enroll in Medicare approved drug discount card programs, with benefits beginning in June 2004, and may continue until the Medicare prescription drug benefit is implemented in 2006.

A key part of the Medicare-approved prescription drug discount card program is a subsidy of up to $600 a year for eligible low-income beneficiaries. Individuals whose income is less than $12,124 each year or married couples whose income is less than $16,363 may qualify for this special help. In addition, Medicare will cover the cost of the enrollment fee for these low-income cardholders. See the Medicare Prescription Drug Subsidy topic for additional information about the subsidy.

You may read the remainder of this topic in sequence, or jump directly to one of the sections listed below:

·          Eligibility

·          Benefits

·          Making a Choice

·          Enrollment

·          Additional Information

Eligibility

You can get a Medicare-approved drug discount card if:

·          you have Medicare Part A and/or Part B, and

·          you don't have outpatient prescription drug benefits through Medicaid (your state may call this Medical Assistance).

If you're enrolled in a state pharmacy assistance program (not Medicaid), you can still get a card.

Almost everyone with Medicare can choose to join a Medicare-approved drug discount card, even people with disabilities who have Medicare and Medicaid. The only people who can't enroll in a Medicare-approved drug discount card are those who have outpatient drug coverage through Medicaid.

If you already have prescription drug coverage through your current health insurance, or you already get discounts on your prescriptions, review your coverage closely to see if this discount card will save you more money on your prescriptions.

Benefits

If you are eligible for a Medicare-approved drug discount card, you can save between 11%-18% on many brand name drugs and even more on generic drugs. This benefit is available to you regardless of your income, and has no effect on your existing coverage. You may have to pay up to $30 annually for a drug card.

If you have limited income, you will not have to pay any annual enrollment fee, and you may also be eligible for an additional $600 credit to help you pay for prescriptions.

Even if you don't qualify for the $600 credit, you can still receive the drug discount card and save money on your prescriptions.

Some Medicare-approved drug discount card sponsors have special arrangements with manufacturers to offer free or low cost medications (which may be important if you have low income).

Making a Choice

When comparing your Medicare-approved drug discount card choices, you may want to review:

·          the drugs covered through each card (including generic alternatives),

·          drug prices (at retail or through mail order), and

·          choice of pharmacies in your area.

Enrollment

To become a member in a Medicare-approved drug discount card, you must complete the enrollment form CMS-20016-A, Standard Enrollment Form For A Medicare-Approved Drug Discount Card. When complete, you must return the enrollment form to the sponsor of the discount card you have chosen. You can only enroll in one Medicare-approved drug discount card at a time.

Once you choose a Medicare-approved drug discount card, you will need to fill out an enrollment form. You can also view and print an enrollment form now. The forms and instructions can be downloaded from this webpage:
http://www.medicare.gov/MedicareReform/formsandinstructions.asp

Depending on the company, you can enroll by:

·          mailing or faxing the completed form to the company,

·          providing your information over the telephone, or

·          fill out your information on the web.

Once your enrollment form has been approved, the company will send you a Medicare-approved drug discount card. The company will also send specific materials you will need, like a member handbook, discount drug list, pharmacy provider directory, and complaint procedures.

Additional Information

The Medicare Drug Discount Card Guide in Easy-to-Use Language web site for people with cognitive disabilities and their families was funded by a grant from The US Department of Health and Human Services Administration on Developmental Disabilities to The Arc of the United States. It uses audio, video, and large text to help explain the discount program. See it online at:
http://www.themedcard.info/

The Medicare Worksheet: Five Steps to Choosing a Medicare-Approved Drug Discount Card is available in PDF format (requires Adobe Acrobat Reader) online at:
http://www.medicare.gov/Publications/Pubs/Pdf/5steps.pdf

The complete Medicare Guide to Choosing a Medicare-Approved Drug Discount Card is available in PDF format (requires Adobe Acrobat Reader) online at:
http://www.medicare.gov/Publications/Pubs/pdf/11062.pdf

You can use the online tool to begin searching for available Medicare-approved drug discount cards and other assistance programs in your area. It is available at:
http://www.medicare.gov/AssistancePrograms/home.asp

See also:

Medicare Prescription Drug Subsidy

Medicare - Overview

Source

http://www.medicare.gov/AssistancePrograms/home.asp

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