Seniors may have to go on drug waiting list

Thursday, Jan. 3, 2002 | 9:35 a.m.

CARSON CITY -- Gov. Kenny Guinn's program for free prescription drug insurance coverage for low-income senior residents may be a victim of its own success.

If enrollment continues to climb at its current pace, the state, within the next month, will place a cap on accepting new members because of a lack of money. A waiting list will then be created.

"We're trying to encourage people to sign up now to avoid the waiting list," said Mike Hillerby, Guinn's deputy chief of staff.

Enrollment, which once lagged, has risen from under 300 in June to about 5,500. "It's gone through the roof," Hillerby said Wednesday.

Enrollment took off after Guinn and Assembly Majority Leader Barbara Buckley, D-Las Vegas, reached a compromise on changes to the program, including the elimination of a monthly premium for seniors.

Jane Smedes, management assistant for Senior RX in the state Department of Human Resources, on Wednesday said that about 500 applications are received each month. But the available money allows only for 6,000 recipients.

When that figure is reached, Smedes said a waiting list will be started. When someone leaves the program, the next individual on the waiting list will be signed up.

Buckley said she was happy to see the escalation and added it came about "without any marketing."

"It's evident that the changes made by the Legislature greatly improved the program," she said.

She said the 2003 Legislature would evaluate the program to learn whether more money may be added to allow for more enrollees.

The state, using money received from the tobacco settlement, pays $106 a month per enrollee to Fidelity Security Life Insurance Company of Kansas City, Mo., for the insurance coverage. That premium is now being renegotiated between the state and the insurance company.

Hillerby said he didn't know whether the present premium will be increased or lowered. Although the price of prescription drugs is increasing, there may be some changes in the program that could offset a higher premium paid by the state.

The average applicant is a single woman in her early 70s with an income of less than $12,500. Seniors who earn less than $21,500 a year are eligible to apply.

Under new rules, Smedes said the state will consider accepting seniors who earn more than $21,500 if certain hardships exist.

Smedes said the breakdown shows 42 percent of the enrollees are from Clark County, 39 percent from rural Nevada and 19 percent from Washoe County.

Under last year's change in the law, the program would have become state-operated if it did not reach 3,500 participants by Dec. 31, 2002. But it reached that level more than a year ahead of schedule. Hillerby said the administration wants to continue with Fidelity Security as the insurer.

The program, started by Guinn in 1999, initially called for seniors to pay part of the monthly premium, about $30 a month. That was eliminated at the suggestion of Buckley, a critic of the slow pace of the sign-ups.

After being enrolled, seniors pay a co-payment of $10 for a generic drug and $25 for a nongeneric drug with each prescription. The maximum benefit is $5,000 per year per senior.