Senior citizens study Guinn’s drug plan

Wednesday, Oct. 11, 2000 | 11:17 a.m.

RENO -- Seventy-four-year-old Jay Robinson says Gov. Kenny Guinn's senior citizens prescription drug program is just the thing a lot of elderly need.

Robinson and his wife, Barbara, say they are considering switching from their present insurance policy with AARP to the program unveiled Tuesday by Guinn at senior centers in Reno and Las Vegas that might save them a lot of money.

"The pharmacy companies are running hog-wild, and there are no controls," says Robinson of Topaz Lake in Douglas County. With his wife, he pays more than $200 a month for drugs, and he says there are a lot of people who are worse off than he is.

Those who are 62 and older with incomes of $21,500 and less can sign up for the subsidy program that will enable seniors to buy drugs at lower prices.

After Guinn's announcement, Assemblywoman Barbara Buckley, D-Las Vegas, said Tuesday her health care committee would hold a public hearing to give seniors and experts a chance to testify on how they view the governor's plan. "I'm pleased they have released the details," she said. "I hope this can make a difference."

The health care committee so far has withheld the $5 million to finance the plan until it gets a chance to take an in-depth look at the policy. Some committee members have been critical, saying there should be a delay to allow the 2001 Legislature to examine the law again.

The state estimates 10,000 to 12,000 people will be eligible. A person must be a resident of Nevada for at least one year and not eligible for Medicaid, which is the medical program for needy citizens.

Sign-ups will start Nov. 1, and the coverage will begin Jan. 1. The state Human Resources Department intends to place applications in senior centers, hospitals, with senior advocacy groups and other places.

Based on a person's income, the state will pay a monthly subsidy towards the insurance premium of anywhere from $10 to $40. For instance those who earn less than $12,700 a year, will receive the full $40 a month.

SeniorRx, as the program is called, offers two plans -- basic pharmacy coverage and enhanced benefit coverage. There are several hundred drugs included, but coverage is excluded for such things as cosmetic drugs, sexual dysfunction drugs and most experimental drugs.

Both the basic and the enhanced plans have $100 deductible per year per member. Each plan has a maximum benefit of $5,000 a year. The basic plan calls for a monthly rate of $74.76 from which the person's subsidy is deducted.

So an individual who gets a $40 a month maximum subsidy would pay $34.76 a month for the coverage.

There is a $10 co-pay for each prescription of a generic drug under the basic plan. For a preferred brand, the co-payment is $35 or 50 percent, whichever is greater. A purchase from a druggist or pharmacy is good for a 30-day supply.

There also is a mail order procedure. The individual, under the basic plan pays $20 co-payment for a 90 day supply of generic drugs and $70 or 50 percent for the preferred branch.

The enhanced policy calls for a premium of $98.31 a month, minus the subsidy. For a generic drug, there is a $10 co-payment and for a preferred branch, the co-payment is $25 a month. Mail order co-payments are $20 for a generic drug and $50 for a preferred brand.

A majority of the national chains and 90 percent of the independent pharmacies are enrolled to accept the business including Albertson's, Green-Valley, Lee's Pharmacy; K-Mart, Medicine Shoppe, Raley's, Rite-Aid, Safeway, Sav-On, Scolari's, Smiths, Von's, Walgreens and Wal-mart.

The program will be administered by Pharmaceutical Care Network, a Sacramento-based pharmacy benefit management company. John Skhal, president and chief executive officer of the company, called this a "unique" program in the nation.

Seniors can get information on the drug program by calling 1-800-243-3638.