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8/8/2004

Daunting discount

By Paula Aven Gladych
The Daily Times-Call

LONGMONT — The Medicare-approved drug discount card program has not attracted the high level of participation officials predicted when the program was first announced last year.

Out of the more than 7 million Americans expected to sign up for the benefit, which started June 1, only 3.6 million have taken advantage of the program, according to the Centers for Medicare and Medicaid Services in Denver.

One Longmont pharmacist, who asked not to be named, said she has seen only a handful of the cards since the program launched.

“A lot of the seniors have the AARP senior card. Some already have something, and these cards don’t necessarily offer a whole lot,” she said. “They cover specific medications. If a patient is not taking those medications, there is no discount to be had.”

There are 493,000 Medicare beneficiaries in Colorado. About 112,000 of those do not have prescription drug coverage, said Helen Collins, special assistant in the office of the regional administrator for the Centers for Medicare and Medicaid Services.

There are also 72,000 low-income Medicare beneficiaries who are eligible for a $600 annual credit on their discount card in both 2004 and 2005. Seniors 65 years and older who make less than $12,569 a year or $16,862 per couple may qualify for the credit.

The Medicare office could not give specifics about how many Coloradans have taken advantage of the program, because seniors sign up with the individual companies offering cards, not with Medicare.

Nationally, about 2 million of the 3.6 million who have signed up for the cards were automatically signed up through their managed-care programs, meaning only about 1.5 million have bought into the card program on their own.

The cards give prescription drug discounts of up to 25 percent, but first seniors have to decide which one of 43 cards would best serve their needs.

The drug cards are temporary until Medicare’s new drug benefit, which was signed into law in December, goes into effect in January 2006.

The pharmacist said the “government is trying to help, but there are not a lot of takers. Seniors are a little smarter than that. They’re investigating intelligently, and if they find it will help, they buy it.”

Seniors must sift through a daunting amount of information to find that card that best suits them.

“Just going to a pharmacy will not give them the answers. We don’t even know what they will charge and what each patient will end up paying right off,” she said. “It seems to be a lot of work.”

Collins said the government has set up a hotline to help seniors choose which card will work best for them.

“We’re really encouraging people to call 1-800-MEDICARE. It takes about 15 minutes to go through the process, and it is a good investment of 15 minutes if you can save on your prescription drug costs,” Collins said.

She admitted that when the program first launched, Medicare had only about 400 service representatives available to help potentially 7 million beneficiaries.

“We’ve increased the number of representatives to 3,000. ... The wait time should be very low,” Collins said.

Participants can also find a drug-cost calculator on the Medicare Web site.

The Department of Health and Human Services has partnered with the Access to Benefits Coalition to find and assist people who need help paying for their medicine.

The coalition — made up of numerous nonprofit agencies, including the Alzheimer’s Association and Easter Seals — will provide up to 50 grants for as much as $40,000 each to foster the development of communitywide initiatives focused on enrolling lower-income Medicare beneficiaries in the public and private programs that can save them money on prescription drugs.

The prescription drug cards and the Medicare drug program, which will start in January 2006, have come under fire from Democrats who claim the program is confusing and offers “no significant savings,” according to The New York Times.

“It sounds good on the surface, but there are so many holes in it,” said Wayne Jones, general manager of the Longmont Regent, a retirement community on North Main Street. “Unless you are almost homeless, it doesn’t help. My people here, it won’t help them.”

Jones, who is eligible for the benefit himself, said that after seeing a presentation on the drug card a couple of months ago, he decided it wasn’t worth his time to sign up.

“It has a lot of frosting and no cake,” he said.

Another Longmont Regent resident, who asked not to be identified, said she didn’t sign up for the card because it was “not enough of a savings. I read very carefully the information I got on it.”

Although she doesn’t have a prescription drug benefit through her health insurance, she said she can buy all of her drugs cheaper in Canada.

“As long as (the Medicare prescription drug) system is cumbersome, old people don’t need another thing to take care of,” she added.

One senior who signed up for the program was impressed with the initial savings he received on his mail-order drugs.

Howard Rumsey, 92, said his children helped him sign up for the prescription card program.

He made a list of the drugs he buys, and then his children went down the list of cards to see which of them “would save me more money. I’m pretty well satisfied with it.”

Rumsey said he paid $140 for a three-month supply of drugs with the discount card. He didn’t have his card on him at the time he spoke with a reporter and couldn’t remember which company it was through.

All of the Medicare-endorsed prescription cards are offered through private pharmaceutical companies or managed-care organizations, such as Anthem Blue Cross and Blue Shield and HMO Colorado Inc. and Sierra Health and Life Insurance Co.

Each card offers discounts on different drugs and costs participants no more than $30 to sign up. Many of the cards have no fee attached.

Participants who decide they would rather have a different card can switch once by the end of 2004. After that, they are locked into the choice they’ve made, according to the Medicare Web site.

The Department of Health and Human Services recommends people who use multiple drugs look at the total savings a card would give, as well as what savings they would obtain by the drug.

As stated on the Web site: “Sometimes the best card won’t discount every drug the person needs, but could provide bigger discounts on his or her most expensive drugs.”

A group called the Healthcare Leadership Council, a nonpartisan coalition of chief executives of companies and institutions across all health-care industry sectors, commissioned a study of the drug card program.

Conducted by Virginia-based The Lewin Group, the survey examined the top 150 drugs most frequently used by seniors and determined how much savings would be available using the discount cards.

It found that on average, seniors “will save over 20 percent at the pharmacy counter. A typical beneficiary without drug coverage who spends $1,727 per year on medicines will save nearly $350,” the survey said.

People with chronic health conditions will save “significantly on their drug regimens,” it said.

As an example, someone with hypertension would “see their annual drug costs reduced from (more than) $956 to $713, a savings of 25 percent,” the survey said.

Paula Aven Gladych can be reached at 303-776-2244, Ext. 211, or by e-mail at pavengladych@times-call.com.