Decision day looms on drug cards

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Decision day looms on drug cards

By Weaver Teichert -- Bee Staff Writer

Published 2:15 am PDT Saturday, May 29, 2004

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Toni Mares Cortez often sits for hours at her desk in front of a row of

prescription bottles lined up alphabetically. She fights fatigue and

frustration at her computer keyboard as she tries to find the cheapest

prices using Medicare's newest tool.

And she's an expert.

Ready or not, however, most Medicare recipients, expert or not, must now

make decisions that could have a big impact on their pocketbooks and maybe

even their quality of life.

Medicare-approved cards for discounts on prescription drugs, the first part

of a major expansion of the federal health-care insurance plan for those 65

and older, become effective Tuesday. The cards will be good only until

January 2006, when prescription drug coverage becomes part of Medicare's

benefits.

Many Medicare beneficiaries apparently still are trying to figure out what

to do. It can be a challenging task to select one -- and only one -- of some

70 discount cards.

Two new studies paint very different pictures of how much the new discount

cards will save seniors who choose to participate.

The Pharmaceutical Care Management Association, a national association for

pharmacy benefit managers, predicts brand name drugs will be discounted 17

percent and generics 35 percent with the cards.

But AARP, which played a key role in getting the law passed, warns that the

price of drugs has climbed three times faster than the rate of inflation for

the past four years. Rising drug prices cancel out most or all of the impact

of projected savings, the nation's largest seniors organization says.

Federal officials say they have no figures on how many seniors have signed

up for the card. AARP, which is sponsoring its own card, mailed out 26,000

enrollment kits, although only 400 people have signed up.

Everyone agrees that one group -- low-income people -- unquestionably will

benefit because of the transitional financial aid they will get until the

full benefit takes effect in 2006.

Couples with a monthly income lower than $1,404 or single people earning no

more than $1,047 are eligible for the $600 credit and to have any card

enrollment fees waived.

" Run, don't walk to a Medicare discount card, " urged Jeff Flick, regional

administrator for the San Francisco office of the federal Centers for

Medicare and Medicaid Services.

For all Medicare recipients, many counselors say enrollment is hampered by

the lack of access or ease with the Internet, problems filling out the work

sheets and misunderstandings about the benefits.

Cortez, program manager for the Health Insurance Counseling and Advocacy

Program in Fresno and Madera counties, spends her days trying to supply the

answers. Using Medicare's comprehensive Web site offering price comparisons,

she types in the names of the drugs, dosage, income, zip code and other

information to come up with a selection of three cards that can save the

most.

The cards offer varying discounts off retail prices for a maximum enrollment

fee of $30 a year.

Beneficiaries who have private health coverage or who qualify for the

state's Medi-Cal program probably won't have to bother with the Medicare

card. But the 10 million seniors nationwide without any coverage will want

to check it out.

Consumer groups have urged seniors also to compare the potential savings

from a discount card with online pharmacies and warehouse stores, because

those savings could be just as much or more.

The challenge has been in figuring out which Medicare card is least

expensive and covers most of the more expensive drugs needed.

Comparison information is available at www.MEDICARE.GOV, which lists the

prices of 60,000 drugs at 50,000 pharmacies nationwide. Beneficiaries also

can call 1-800-MEDICAR (633-4227) for help.

The first week that information was available, 1.6 million calls overwhelmed

the phone lines. In response, Medicare increased the number of operators

taking phone calls to 2,000 from 400, Flick said, and callers now have an

easier time getting through.

He added that information available on the Web site is more complete than a

month ago when it made its debut, and that prices are dropping.

But the comprehensiveness of the Web site may be overwhelming to many

beneficiaries.

When Pam Power, Sacramento's Health Insurance Counseling and Advocacy

Program manager, tried to figure out which card would be best for her

mother, she got a printout of 76 pages of price comparisons.

When she helped consumers in Grass Valley, she learned that two of the

pharmacies suggested by Medicare had been closed for some time.

At a Fresno senior center, Cortez talked with many seniors who didn't know

the basic information needed for a search. " I take a water pill, " was all

one elderly woman could tell Cortez about her prescription needs.

Cortez has revamped her checklists several times and now asks seniors to

bring in their prescription bottles to get the needed information.

" They (beneficiaries) are relatively confused about what it is they need to

do, " said Bonnie Burns, director of training for California Health

Advocates.

Burns has heard that some card sponsors have given out incorrect information

and some health maintenance organizations have not yet notified their

members about the card they'll receive. HMO members can only get the card

offered by their plan.

Flick of the federal Centers for Medicare and Medicaid Services, said the

enrollment procedure has gotten less complicated in the last couple of weeks

as the Web site has taken shape.

" I just did it for my mother-in-law. It was that easy, " he said. " It's a

very dynamic process that seems to be working extremely well even though for

a while we did scramble. "

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About the Writer

---------------------------

The Bee's Weaver Teichert can be reached at or

nteichert@....

For more information

Information on the Medicare drug discount card and other

prescription-assistance programs is available at:

* Official Medicare Web site, www.medicare.gov, or by phone (800) MEDICAR

(633-4227).

* California Health Insurance Counseling and Advocacy Program, (800)

434-0222 for free one-on-one advice.

* National Council on the Aging, www.benefitscheckup.org/ to learn about

prescription coverage and other benefits for people 55 and older.

Source: Bee research