Medical Discount Cards: Big Dose of Confusion

7:12 pm Health Stories

Wilkes-Barre Times LeaderJune 6, 2004 Sunday MAIN EDITION

BYLINE: DAWN SHURMAITIS Special to the Times Leader

Armed with slides and handouts, simple language and great patience, Joe Giebus and Anne Rappaport face an anxious crowd of seniors eager for easy answers on the new discount drug program.

But when the Area Agency on Aging representatives finish their 30-minute spiel, they’re met with blank faces and raised hands. Reactions range from “I’ll never understand it” to “It takes a lawyer to figure this out.”

Whether they’re in Nanticoke, Hazleton, Pittston or Tunkhannock, Giebus and Rappaport continually confront the same dilemma: explaining the nearly unexplainable.

“If you think it’s confusing, I agree,” says Rappaport, who has spoken along with Giebus at numerous senior centers in Luzerne County about the new prescription drug cards, which became available last week.

While pharmacists expected a rush from those seeking savings on their prescription medications, for the most part it hasn’t happened. Many baffled seniors already struggling to pay for costly prescription drugs on limited incomes say no matter how hard they listen and how many pamphlets they read, it’s still difficult to decide which card – if any – to choose.

“My husband’s been reading everything and I even talked to Medicare on the phone and I still couldn’t get any understanding,” says Myrtle Paige, who came to the Nanticoke Senior Center with her husband, Albert, hoping for definitive answers. “I think it’s utter confusion.”

All but about a half-million of the 2.87 million cards approved by the government nationwide have been issued to people who participate in Medicare managed-care plans and who were automatically enrolled in the card offered by their insurer.

The problem, say Rappaport and Giebus, is that there are so many variables to consider. “Obviously, every situation is different. Shop and compare,” says Giebus.

The cards will provide discounts for Medicare participants who have no other prescription drug coverage. In addition, certain low-income participants will be eligible for subsidies, also known as credits, of $600 a year.

There are 17 different Medicare-approved discount drug cards being offered in Pennsylvania alone. The cards, which are optional and cost no more than $30 a year, can save users up to 30 percent on prescription costs. Average savings are 10-15 percent.

Some companies might also offer discounts on over-the-counter medicines as well as medical supplies. Discounts vary by card and each card is slightly different.

Who can apply? Anyone enrolled in Medicare except people who get their drugs through Medical Assistance. You can only get one card. However, you may still keep any other discount cards you have as they might offer better discounts.

The cards are being offered by private companies that include health insurers, Medicare HMOs and pharmacy benefit managers. Seniors say they’ve received numerous brochures in the mail pushing the various cards. Some have also received information from Medicare and AARP.

Luci Conti, who is 80 and fills three to four medications a month for arthritis, osteoporosis and other ailments, attended a recent talk in Nanticoke to clear up some questions about the subsidy and PACE, a state health insurance program that pays for prescriptions, minus a small co-pay.

About 15,000 seniors in Luzerne County are on PACE or PACENET. If you are on these programs, and your prescriptions are already paid for, you don’t need a discount card.

But if your income is low enough (a maximum of $12,569 for singles and $16,862 for couples), you could qualify for the $600 subsidy – if you’re on Medicare and under age 65.

“My druggist explained it to me,” says Conti, of Nanticoke. “But then a lady in the store told me something else. So that’s why I’m here today. To find out.”

Rappaport and Giebus field numerous questions wherever they go. When they can’t answer, they refer the seniors to 1-800-Medicare, 1-800-783-7067 or the Web site www.medicare.gov. If you call, tell the operator you are from Pennsylvania and what drugs you regularly take. The operator will then tell you which cards you are eligible for. You can choose only one.

Beware of anyone calling you or knocking on your door to sell prescription cards, Rappaport and Giebus caution. No one is allowed to sell the discount cards door-to-door or by telephone.

“Please, please, please read what you get in the mail,” Rappaport says. “Please be careful what you’re signing. Watch out for fraud. Do not give your Social Security number to anyone.”

Also, make sure the card you finally agree to use has “Rx” in big letters and the Medicare logo on the face. The logo means the card has been approved by Medicare.

In the end, Glen Lyon resident Peter Tkatch put it this way: “People up in age don’t understand it and get scared. Me, at 84, I don’t worry anymore. ”

USEFUL TO YOU

Answers to your questions about drug discount cards from the Area Agency on the Aging:

Should I get a discount card?

Not if you’re on PACE or PACENET (the state’s drug program for those 65 and older). You won’t benefit from the prescription cards. If you already get prescription benefits from your former employer, or as a veteran through the VA, you also do not need the card.

If you’re on Medicare A or B, get a card. If you’re single and your income is more than $23,500 or married with an income of more than $35,000 – which means you don’t qualify for PACE or PACENET – get a card.

How much will it cost and how much will I save?

Fees range from zero to $30 a year. Discounts vary, but could be as large as 30 percent. Some cards have restrictions on the type of drugs you can buy.

Which card should I get?

It depends on your situation. Many local pharmacies are advertising that they will answer questions about the cards for their customers. Carefully read the brochures and make sure you get the card that works best for you. Compare the cards. What’s the enrollment fee? How much is the discount? What drugs are accepted? Some pharmacies and drug companies also offer their own discount cards.

 

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