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Medicare Discount Drug
Card
INFORMATION FACT SHEET
Medicare Prescription Drug,
Improvement and Modernization Act of
2003
Medicare Drug Discount Card
effective June 1, 2004
Full Medicare Drug program
begins January 1, 2006
EPIC Automatic Enrollment
into First Health Discount Card
for those less than 135% of
poverty in May 2004
Medicare Drug Discount Card
(1) Overview:
Interim program lasting 18
months from June 1, 2004 -
December 31, 2005
Available to all Medicare
beneficiaries with an expected
savings of 10-25% of current
costs for prescriptions
Cards will be offered by
HMOs, PPOs, insurance companies
and pharmaceutical companies (see
list)
Additional savings for low
income beneficiaries through the
Transitional Assistance Program
for individuals below 135% of
the FPL
Not available to those with
prescription drug coverage
through: Medicaid, TRICARE
Military Health Services,
Federal Employee Health Benefit
Program, or an employer
(2) Use of Drug Discount Card:
Each card sponsor must
discount at least one drug in
each therapeutic drug category.
Discounts can change throughout
the year and even be entirely
eliminated. Elderly consumers
should be encouraged to
research available cards to find
out which cards offer the
best discounts for their
needs
Only certain pharmacies
will participate with
certain card sponsors -
individuals should contact their
pharmacy or the card sponsor
directly to find out if their
local pharmacy is covered
Card sponsors may charge an
annual enrollment fee for
joining their drug card program.
This fee may change next year,
however, it will never exceed
$30.00/year
Once a card is chosen,
individuals are able to cancel
their card membership at any
time, however, they will not be
able to join a new card until
open enrollment from November
15, 2004 - December 31, 2004
No discounts will be offered
for barbiturates,
benzodiazepines, fertility
drugs, vitamins, weight-related
drugs, over the counter drugs,
and any drugs covered by the
existing Medicare Part B
coverage
EPIC enrollees should
investigate the discount card
options available to them
because while EPIC may provide
some out of pocket savings, more
savings could be gained through
one of the discount cards
(3) Low Income
Transitional Assistance Program:
Low income EPIC seniors will
have their EPIC enrollment
fee waived, be able to
maintain their EPIC benefits,
and still receive the $600
transitional assistance which
will significantly reduce their
costs
EPIC seniors will be
automatically enrolled in the
First Health Service Drug
Discount Card, and will
receive one EPIC/First Health
card in the mail
EPIC seniors can opt out
of the auto-enrollment by
contacting EPIC directly
EPIC seniors may enroll
another drug discount card if
they choose, however they
will not receive the waived EPIC
enrollment fee with that card
Available for consumers with
an annual income below 135%
of the Federal Poverty Level
- $12,659 for singles and
$16,862 for couples
Given a $600 credit each
year to use toward the cost
of prescriptions tracked by the
card sponsor
No annual fee for
enrollment from the card sponsor
Unused 2004 credit will carry
over to use in 2005, but
ends December 31, 2005, when the
Discount Card program ends
Medicare Managed Care and the Drug
Discount Card
Managed care seniors should
contact their plan directly
for the best information on how
they may be able to use the drug
discount card program.
Managed care plans may choose
to automatically enroll their
members into one specific card.
Enrollees are required to use
that card for prescription drug
coverage.
If a managed care company is
a sponsor of a drug discount
card, open to non-members,
managed care members can
research and join any card that
is best for them.
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