Medicare's new card deal wrong prescription, elderly say

More than a month after the nation's Medicare-approved drug discount cards program took effect, local pharmacists say they've seen little interest in the cards from the area's elderly.

"We haven't seen anybody use a card yet," said Becky Maintz, manager of Southeast Pharmacy at Doctors' Park in Cape Girardeau.

"It is confusing to us," she said of the 36 discount cards available to area Medicare recipients. Maintz said it probably is even more confusing for the elderly.

Pharmacists at Broadway Prescription Shop have handled only about five transactions involving discount cards since the program started on June 1, office manager Michelle Flath said.

Like Maintz, Flath said the program's varying discount cards and costs make it hard on the consumer and even pharmacies. "Pharmacies are still scratching their heads," she said.

Some senior citizens agree it's hard to make sense out of the program, much less negotiate their way through Medicare's automated switchboard or even the agency's cumbersome Web site.

Others don't believe they will be helped enough to go through the paperwork and pay an annual enrollment fee of as much as $30.

"Why waste your money?" asked Darel Roberts of Cape Girardeau as he ate lunch at the Cape Girardeau Senior Center on Thursday.

His brother, Frank Roberts of Jackson, also decided against getting a discount card. A 73-year-old veteran, Frank Roberts gets his prescription medicine through the Veterans Administration.

Frank Roberts said he's gone online, seeking out information on the discount cards from the government's Medicare Web site. Roberts said he saw nothing on the Web site that made him want to take a closer look at the discount cards.

But some elderly, particularly those with low incomes, said the discount cards are a help.

Mildred Followell of Cape Girardeau signed up for a pharmaceutical company's "U Share" discount card. Because of her low income, she will qualify for a $600 annual drug credit.

She estimated the discount card will save her about $150 a month on her blood pressure and cholesterol medication.

The $600 drug credit is in addition to price discounts. Low-income Medicare beneficiaries who get the $600 credit must pay a co-payment of 5 percent or 10 percent, depending on income, each time they make a drug purchase using the subsidy.

Once the $600 is spent, participants would continue to get discounts on drug purchases at the full discounted price. Those prices can change over the course of the year.

Eligible participants get the full $600 credit no matter when they apply this year. As long as they have a Medicare-approved drug discount card, they will receive another $600 credit next year.

"You have to be low income to really take advantage of it," said Followell, one of 3.6 million Americans nationwide who have signed up for drug discount cards.

Automatic enrollment

But of those who signed up, an estimated 2.4 million were automatically enrolled by their health insurance programs, said Deane Beebe, a spokeswoman for the not-for-profit Medicare Rights Center in New York City.

Only 1.2 million Americans signed up on their own, she said. Even the 3.6 million is a fraction of the 41 million Americans who are eligible to participate.

"As you can see, it is not a sweeping success," she said.

Beebe said so far the discount cards have been more political hype than anything else, except for the very poor who benefit from the $600 drug credit and extremely low co-payments.

"For everybody else," she advised, "shop around."

Beebe said many elderly will find they can save more money by enrolling in discount programs offered by specific pharmaceutical companies, through state programs such as the Missouri Senior Rx program or by buying their medicines from pharmacies in Canada.

Mail-order purchases also may offer considerable savings, she said.

The discount cards, however, can offer some savings even for those who don't qualify for the $600 credit.

Lipitor, a medication to combat high cholesterol, can cost about $88 at a retail pharmacy in the Cape Girardeau area. With some discount cards, the cost for 30 tablets is less than $65, a savings of about $23.

Janet Smith, director of the APPLE Paperwork Service in Cape Girardeau, which helps the elderly with paperwork on everything from taxes to Medicare, said those who qualify for the $600 drug credit should obtain a Medicare-approved discount card.

In addition to the credit, low-income elderly don't have to pay an annual enrollment fee, Smith said.

Those who have military insurance or federal employee or retiree health insurance don't qualify for the $600 credit. Americans who have other health coverage that includes outpatient prescription drugs also may not qualify, Smith said.

For those who don't meet the low-income guidelines and don't qualify for the $600 credit, the discount cards may be more of a gamble.

Smith said a person may find a card that provides significant savings or might find it's not a major benefit depending on the card, the discounts and the drugs that are covered.

The different discount cards don't all cover the same drugs. People have to do their homework, she said.

But that isn't always easy, area elderly say.

Betty Ford, 73, lives in a senior citizens apartment complex in Cape Girardeau. Ford said her low income qualifies her for the $600 credit.

She recently signed up for a drug discount card with the aid of her pharmacy, Broadway Prescription Shop.

"It will help a lot," said Ford, who takes three medications to regulate her blood pressure and a fourth for osteoporosis. She estimated it could save her more than $200 a month.

Medicare officials and politicians routinely advise senior citizens to check the Medicare Web site and type in their medications to determine what discount card would be best suited for them.

But Ford said she didn't have access to a computer, forcing her to rely on her pharmacy and a toll-free Medicare number for help.

"A lot of us don't have a computer and we couldn't afford one anyway," she said.

mbliss@semissourian.com

335-6611, extension 123

MEDICARE DISCOUNT-CARD Q&A

Who is eligible? Anyone enrolled in the federal Medicare program.

Who provides the discount cards? Private companies provide the Medicare-approved cards, and the savings vary depending on the card.

What do the cards provide? According to Medicare, the cards offer savings ranging from 10 percent to 25 percent -- on average -- off the retail price of brand-name drugs. Larger discounts are available by ordering drugs through a card sponsor's mail-order pharmacy or by purchasing generic drugs.

Are there special benefits for low-income Americans? Yes. If your annual income doesn't exceed $12,569 if you are single or $16,862 if you are married, you could qualify for a $600 credit on your discount card to subsidize the purchase of prescription drugs. Low-income Medicare beneficiaries who get the $600 credit must pay a co-payment of 5 percent to 10 percent each time they make a drug purchase using the subsidy.

Where can senior citizens get advice on drug discount cards and how to apply? They can contact Medicare at www.medicare.gov or (800) 633-4227. Those who are age 60 or older who live in Cape Girardeau, Scott, Perry or Bollinger counties can contact the APPLE Paperwork Service in Cape Girardeau for assistance at 651-5467.

Are there fees involved? Yes. Card sponsors can charge an enrollment fee of up to $30.

Can I switch cards whenever I want? No. Medicare regulations state that senior citizens who choose a card must use that card for the rest of the year. Participants may choose a different card during an open enrollment period beginning in mid-November, but they can't use the new card until 2005.