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Medicare Urges Seniors to Wait for Best Drug Card Choice

Posted - Apr. 29, 2004 at 1:40 p.m.



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Apr. 29--Warning to senior citizens: When Medicare turns on its price comparison Web site today, don't sign up for the first card that fits your needs.

That's the advice from the Centers for Medicare and Medicaid Services. The reason is that pricing information will be available today for only 35 of the 72 drug discount cards. The rest will be phased in by mid-May, Medicare said. The information will be available online or by calling a toll-free phone number.

Even the posted prices that appear today might change, as card sponsors see what drug discounts their competitors are offering.

Today was the day that Medicare said it would make public all drug-card prices so that senior citizens could begin shopping for a card.

But Medicare said some card sponsors had not yet provided accurate pricing information, card terms, and benefits that Medicare beneficiaries "need to see," Mark McClellan, administrator of Centers for Medicare and Medicaid Services, said yesterday.

"They cannot market until we've said that their marketing materials meet our standards," said Medicare spokesman Peter Ashkenaz. "Prices will be there for some, but not for others. There will be more up there on Monday, and the week after that."

The cards are supposed to provide interim savings on prescription drugs until a full Medicare prescription-drug benefit begins in 2006.

But what had been a complex, interim step to provide relief and $600 assistance for low-income Americans has become more confusing.

When Medicare beneficiaries go to the government site, www.medicare.gov, or call toll-free 1-800-633-4227 to compare cards, they must provide their zip code, then their income level, and finally the drugs they use.

Based on that information, a list of cards offered in their area, prices and participating pharmacies will pop up. In Pennsylvania, for example, 28 or 29 cards will be available to choose from.

Enrollment can cost up to $30 a year.

"We are recommending that seniors take their time to look at all the information they can -- and even wait," said Medicare's Ashkenaz.

"Don't rush in and sign up with the first card you see. While it is possible to sign up for a card as early as next week, you can also wait until later in May, without missing the discounts available.

"The prices may change, and become lower, as sponsors see what their competitors are going to charge," he said.

Medicare officials said yesterday that price information for 35 cards would be available today on its government Web site, or from operators at a toll-free Medicare number. Pricing for 37 other cards will be available in the next five to 10 days, and no later than mid-May, Medicare said.

The federal government said the discount cards would offer savings between 10 percent and 25 percent off retail prescription drug costs, but critics said the percentages would be much lower.

Another reason to wait is that Medicare might still approve more cards, and once seniors enroll, they have to stick with one Medicare-endorsed card the rest of this year. Switches can be made for 2005.

Card sponsors can begin marketing the cards Monday; enrollment begins the same day. The cards can be used starting June 1.

Although Medicare announced in March that 28 companies had been approved to offer discount cards, that number has risen. There are now 39 national cards and an additional 33 that are regional or state cards that can be sold to residents in a particular state, but can be used in pharmacies across the country.

The cards may offer discounts on different drugs and in differing amounts, but at least one drug in each of 209 categories of medicines. Different pharmacies will accept different cards.

Some cards, such as those offered by Independence Blue Cross, AARP and Aetna, will have "open" formulary lists and offer discounts on about 60,000 Medicare-approved medicines.

Medicare said it would require card sponsors to update their prices every seven days. The government estimates that more than seven million people, most of them now without prescription-drug insurance, will sign up for cards. More than four million people are expected to qualify for the low-income subsidy.

For low-income people who are not already receiving Medicaid, the decision to get a card is easy. It will not cost anything and it comes with $600 to spend on prescription drugs this year and another $600 in 2005.

Which card to pick is another matter. Tim Trysla, policy adviser for CMS, said he hoped most card prices would be posted in the next five to 10 days. He said the prices consumers saw on the Web for a card and for a drug would be the price they paid at the pharmacy.

CMS's McClellan said Medicare's 24-hour-a-day hotline, 1-800-633-4227, has been inundated with calls, asking for help in choosing a drug discount card.

The number-one question is about the $600 credit on the discount card for low-income beneficiaries, how to enroll, and the cost of the drug card, he said.

Even seasoned counselors are struggling to come up with easy-to-understand answers for Medicare recipients of all incomes.

Several groups that advocate for older people as well as state health insurance assistance programs are offering help.

A survey of card sponsors found that the cards would produce average discounts of 17 percent for brand-name drugs and 35 percent for generic drugs, according to the Pharmaceutical Care Management Association, an association of pharmacy-benefit plan managers.

Critics expect more modest savings, noting that prescription prices are rising around 15 percent a year.

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To see more of The Philadelphia Inquirer, or to subscribe to the newspaper, go to http://www.philly.com

(c) 2004, The Philadelphia Inquirer. Distributed by Knight Ridder/Tribune Business News.

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