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Prescription Discount Drug Cards:
A Step Forward

Companies that are approved must offer their Medicare discount drug card to every person who has Medicare in each of their targeted states, unless the company is a Medicare Managed Care plan. Which prescription drugs will be discounted and what the amount of the discount will be is determined by each individual company. You will need to carefully compare each card in order to choose the one that offers your prescriptions at the lowest price. Many of the companies offering a Medicare-approved drug card will have a discount drug list that you will be able to access to see which drugs are being discounted. When you choose to go with a particular discount card, you may get a lower price only on the prescription drugs listed by the discount cards’ corresponding company. Realize that a company can change its discount drug list and the discounted prices at anytime. The company will give you information about, and changes to, its discount drug list only if you ask them for such information. ion. ion. ion. ion. ion. ion.

By asking yourself some of the following questions, you may be able to make a better-informed decision: Which card offers discounts on most of the prescriptions you take? Which discount card gives you the best overall price on all of your prescriptions? Which company allows you to use the pharmacy you want? Once you’ve made your decision, you can then call the private company and request an enrollment form. Once your enrollment form has been approved, the company will send you the Medicare-approved drug discount card, along with a member handbook, discount drug list, pharmacy provider directory, and complaint procedures. In order to receive the discount on your prescriptions, you must go to one of the pharmacies listed in the pharmacy provider directory. If you don’t go to a pharmacy on this list, you may not get the discount on your prescriptions. You can not enroll in more than one Medicare-approved discount drug card at a time, however, if you have a non-Medicare-approved discount card, you can use these in combination with one Medicare-approved drug card. Also, if you move to another state where your current discount card isn’t offered, you will be able to enroll in another discount card. Should you live part-time in more than one state during the year, you are still only allowed enrollment in one Medicare-approved discount drug card, so make sure you choose a discount card that is offered in all of the states where you have residency.

Some more basic information you may need to know:

What happens if you choose a discount card and then your doctor changes your prescription?  You need to give your doctor a copy of the discount drug list which corresponds to your discount card. Your doctor can then look to see if a particular medication is on this list. If your doctor needs to prescribe a drug that can’t be found on the discount drug list, and you don’t have any other health insurance that covers outpatient prescription drugs, you will probably have to pay full price for the prescription.

What should you do if a company offering a Medicare-approved discount drug card contacts you directly? You need to compare the card they are offering you to other discount card choices before you make a final decision. Most importantly, you need to verify the legitimacy of any discount drug card which touts itself as “Medicare-approved.”

Can you get a Medicare-approved discount drug card if you’re already in a Medicare Managed Care plan? Yes you can. Your Medicare Managed Care plan may offer a Medicare-approved discount drug card only to its plan members. If it does, you can choose to join only this discount card. If you choose not to join the discount card offered by your Medicare Managed Care plan, you will be unable to choose another Medicare-approve discount drug card. If your Medicare Managed Care plan doesn’t offer a Medicare-approved discount drug card, or if they offer a discount card that is open to non-members, you can choose any discount card offered in your state. Call your Medicare Managed Care plan for more information.

Can you leave a Medicare-approved drug discount card? Yes, you can leave at anytime by notifying the company and telling them why you are leaving. If you must leave for any of the following reasons, you can choose a new discount card anytime: you move to a state in which your discount card isn’t offered; you join or leave a Medicare Managed Care plan; you enter or leave a long-term care facility (like a nursing home); the private company stops offering your discount card. If you choose to leave the program in 2004 for any reason other than those listed above, you can apply for a new discount card beginning on November 15, 2004, and you can begin to use your new discount card beginning in 2005. If you choose to leave the program in 2005 for any reason other than those listed above, you will not be allowed to apply for another new discount card.

What happens if a company stops offering your particular discount card? Should a company stop offering your discount card, they will have to notify you in writing within a reasonable amount of time. At this point, if you choose to join another discount card, you will have to pay the annual enrollment fee again.

For more information, contact:

U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244-1850
www. Medicare. gov on the web
800-MEDICARE (800-633-4227)
 

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