07 December 2004

Switching Between Medicare Cards Year-End Deadline Looms To Select One Offering Deeper Drug Discounts

If you aren't happy with your Medicare prescription-drug discount card, now is the time to do something about it.

Medicare's discount-card holders have until year-end to drop their current cards and sign up for a different deal under the program for next year. There is no requirement for card holders to switch during this period, which started Nov. 15. But shopping around could mean finding deeper discounts.

"Go back and just make sure that you're on the card that's best for you, given the drugs that you're taking right now," says Dee Mahan, deputy director of health policy for the consumer-advocacy group Families USA.

The discount-card program, which started midyear, is meant to help seniors get cheaper drugs until Medicare's new drug benefit begins in 2006. Switching cards for 2005 may make sense if a senior's current card has changed its discount prices for certain drugs, or if the card holder is taking different medications that would be cheaper on another card, Ms. Mahan says. (Disabled Medicare recipients are also eligible for cards.)

People who don't yet have cards can sign up any time until the end of next year. While some cards are free, others carry an annual enrollment fee of as much as $30. Low-income recipients should try to make the Dec. 31 deadline. By doing so, they can take advantage of a $600 government credit in 2004 that can still be used next year for buying drugs. To qualify for the credit, Medicare recipients must have incomes of not more than $12,569 for singles or not more than $16,862 for couples, and not already be enrolled in other drug-coverage programs including Medicaid or through a former or current employer.

Using a discount card can provide savings. According to a survey released yesterday by AARP, of 510 Medicare beneficiaries surveyed who had signed up for and received a card sometime from June to October, those who had used the card had saved an average total of $154 a person on prescriptions in that period. The survey results suggested that many people signed up for whatever card they had received information about in the mail.

The federal Centers for Medicare and Medicaid Services attempted in early summer to reduce confusion about the cards by making some improvements to the process of comparing them. The agency's Web site, Medicare.gov, for example, has an option to narrow the list of cards it suggests to users of the site, showing the five lowest-priced cards. CMS also increased its call-center staff, to 3,000 from 500, to reduce the wait time for people who call the CMS toll-free telephone number, 1-800-Medicare.

For some people, switching cards may be untenable. As of June, about 2.3 million Medicare beneficiaries were automatically enrolled in a discount card through their Medicare Advantage plan, with an option to decline the card if they wanted to, according to America's Health Insurance Plans, a trade group of major insurers. Those Medicare Advantage plans and some others offered discount cards exclusively to their members. In those cases, the Medicare Advantage enrollees can't switch cards unless they change to a different Medicare Advantage plan for their Medicare coverage, or switch to the traditional Medicare plan.

For seniors for whom a change might make sense, there are some issues to keep in mind.

Though consumer advocates had worried that discount prices available through the cards might change dramatically after a consumer signed up, so far the discounts have remained fairly stable, says Tricia Neuman, director of the Medicare policy project at the Kaiser Family Foundation. But there are some cards that offer better discounts than others -- and the ones that were cheapest or most expensive six months ago haven't always maintained those distinctions.

"The key issue is what the discount is," Ms. Neuman says. "There's nothing that locks the discount amount into place."

There are also options outside of the Medicare card program. Retailers such as drugstore.com or Costco Wholesale have competitive deals, and drug companies and retailers also have their own discount cards or other programs, separate from the Medicare program. Some are limited to low-income consumers. Several states also run their own discount programs. Certain ones are limited to low-income recipients, and others are open to all Medicare recipients. A list of the available options can be found at www.medicarerights.org3, a Web site maintained by the Medicare Rights Center, an advocacy group for Medicare recipients.

To find out what is available through the Medicare program, visit the medicare.gov4 site or call 1-800-Medicare. Be prepared to provide your zip code, your monthly income, the names of your medications and the dosages you take, and your monthly costs for the drugs.

For information about Medicare's program as well as other options that may be available, you can also use the site benefitscheckuprx.org, run by a coalition of about 80 organizations that deal with issues related to health and the elderly.

By SARAH RUBENSTEIN THE WALL STREET JOURNAL

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