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-- Programs and Services -- Contact Information Shine Answers: Important answers about the Medicare drug discount card
Prepared by Elder Services SHINE Program
Q. What are Medicare-endorsed drug discount cards?
A.
Medicare has contracted with private companies to offer drug discounts to
eligible participants until the Medicare prescription drug benefit starts in
2006. The cards are designed to save you approximately
10% off brand name drugs and up to 30% on generics.
Q. How much does each card cost?
A.
Each card will cost no more than $30 yearly. You can only sign up for one card
per year.
In 2005, you choose a different card or stay on the same card.
Q. Who is eligible to get a drug discount card?
A. Anyone enrolled in Medicare Part A and B.
Q. Are there any exceptions?
A. Yes. If you are on Mass Health/Medicaid you are not eligible.
Q. How does one sign up for a Medicare-endorsed card?
A. There are two main sources of information: You can visit the Medicare website www.medicare.gov or call1-800-MEDICARE (1-800-633-4227). You will be asked a series of questions including what your zip code is, the names of your prescription drugs and dosages, what pharmacies you prefer and how many miles you are willing to travel. From that information a list of available cards, contact information, card and drug prices will be generated. Trained SHINE counselors can help explain options and comparisons. (See below.)
Q. We hear that the program reaches out to lower income individuals, how does that work?
A. If you are single and your income is less than $12,569, or if you are married and your combined income is less than $16,862, you are eligible for a $600 “transitional assistance” credit for 2004 and 2005. You will have to pay a 5-10% co-pay for each medication. You still select a discount card; present it at your pharmacy where you will start a declining balance until you spend $600. In addition to this, the enrollment fee will be waived.
Q. Are there any people who are disqualified for the $600 “transitional assistance” credit by their existing health insurance policies?
A. Yes. If you are covered by the following health insurance plans you are not eligible to apply for the $600 credit:
· Mass Health/Medicaid
· TRICARE for Life
· Veterans Insurance
· Federal Employee Health Benefits Plan
· Employer/ retiree group health plans that cover prescription drugs.
Q. How does one apply for the $600 “transitional assistance” credit?
A.
First choose a Medicare-endorsed card by reviewing the discount drug list, drug
prices, and choice of pharmacies.
When completing the discount card enrollment form, be sure to complete the
section for the $600 credit.
Q. What if I’m enrolled in Prescription Advantage?
A. Stay enrolled!! This state-run program is one of the best available in helping elders afford prescription drugs. Continue to carefully read each piece of mail from Prescription Advantage. If you are eligible for the $600 credit, you should have received or will soon be receiving information on enrolling in this portion of the program. Follow all instructions in any mailing you receive.
Q. We’ve been seeing other companies offer cards – how do these work?
A. Only information on the Medicare-approved cards is available on the Medicare website. Other companies and manufacturers may continue to offer other discount cards independently. You will need to compare all options and decide what best meets your needs
Q. What is a SHINE counselor?
A. SHINE stands for Serving the Health Information Needs of Elders. SHINE counselors have been trained to help you navigate through the health care system and provide unbiased information and options. They will help you access the information needed to help you make informed decisions.
Q. How do I get in touch with a SHINE counselor?
A. Call Elder Services at 413-499-0524 or 1-800-544-5242, or call your local Council on Aging and make an appointment with a SHINE counselor.