Savings in the cards
Picking the best Medicare drug discount card is tougher than ever
The wallets of senior citizens sure have been getting fatter over the past few years--but not from extra cash. Instead, they've been bulked up by the host of prescription discount cards sponsored by groups ranging from AARP to drugstore chains. The most recent entrant into the discount derby? Uncle Sam. As part of the Medicare bill passed last year, the government in May began offering a discount-card program aimed at the more than 13 million Medicare beneficiaries without prescription drug coverage. It's intended as a stopgap measure to give some relief before the more extensive--and more complex--Medicare drug benefit kicks in at the beginning of 2006. Four months after launch, the program is garnering mixed reviews. And while there is still no quick rule of thumb for deciding whether the federally endorsed discount card is the best choice, some trends have emerged that make it easier to sort out.
First, a short primer. The card program is voluntary and open to any Medicare recipients who aren't covered by Medicaid, though it is less likely to be helpful for those who already have good private drug coverage. Participants sign up online or by mail for one of numerous national or regional cards, all of which have the Medicare seal of approval but are sponsored by for-profit entities, mostly pharmacy benefit managers or managed-care companies. Choosing a card is complicated, but key factors to take into account are which programs are accepted by local drugstores, which drugs are covered, and the size of the discounts on the drugs you take. (Most cards also offer a mail-order option.)
Once you've chosen a card, which may have an annual enrollment fee of as much as $30, you're locked into that program for a year--though card sponsors can change prices at will, a much-criticized provision of the program. (Despite fears of bait-and-switch price hikes, two studies have found that prices haven't significantly moved since June.) Another provision of the new law gives a free card and a $600 drug-purchase credit to low-income cardholders--individuals who make less than $12,569 or couples making less than $16,862--who don't already have coverage through Medicaid.
So, after three months, what's the verdict? Measured by foot traffic, not good. About 4.3 million people are now enrolled in the program, according to the Centers for Medicare and Medicaid Services, including over 1 million who qualify for the $600 low-income credit. That doesn't bode well for getting CMS, as the Medicare agency is known, to its target of 7.3 million people signed up by the end of this year. Even President Bush said in June that "we've got some problems" with the cards. And the interest may have fallen off recently. "We had a forum scheduled in Orange County at a retirement community where they usually get several hundred people for anything," says Bonnie Burns, training and policy specialist with California Health Advocates, a consumer group. "They asked us to cancel."
Confusion. Why so little interest? Advocacy groups like Families USA and the Medicare Rights Center criticized the sign-up as confusing. Initially, the website designed to compare the programs (www.medicare.gov) had bugs--including problems listing correct dosages for liquid medicine--and calling the help line (1-800-MEDICARE) produced interminable waits. Since many elderly people lack Internet access or have trouble hearing over the phone, sons, daughters, and neighbors have stepped in--and they have found the process complex as well. "I spend my life doing policy-wonk stuff, and I was confused trying to help my mother," says Gail Shearer, director of health policy analysis with Consumers Union. Without some Internet savvy, or help from a friend or relative, evaluating the cards was extremely difficult.