Medicare recipients may lose thousands in benefits

Michelle Swafford

Wednesday, Dec. 29, 2004 | 11:24 a.m.

To sign up for the $600 prescription-drug credit by Friday, call (800) 633-4227 or visit www.medicare.gov.

Tens of thousands of Nevada Medicare recipients could be in danger of losing $1,200 in prescription-drug credits if they don't apply by Friday.

About 44,000 low-income Nevadans are eligible for the Medicare assistance program, but thousands have failed to sign up.

Medicare beneficiaries who earn less than $1,048 per month ($12,569 per year) or couples who earn less than $1,406 per month ($16,862 per year) and do not have other prescription coverage through an employer or government program have until Dec. 31 to apply for a $600 credit for 2004. Unused money carries over to 2005 and is added to $600 that is issued for 2005.

The Centers for Medicare & Medicaid Services estimates that 66,000 of the 273,000 Nevadans eligible for Medicare do not have prescription drug coverage. Medicare is a federal health insurance program for people age 65 and older, people with certain disabilities who are less than age 65 and people with end-stage renal disease.

Of the Medicare recipients that do not have drug coverage, about 44,000 are considered to be low income and would likely qualify for the financial assistance. The credit is automatically credited to the drug-discount card and can be used to defray drug bills. The cardholder is still responsible for between 5 percent and 10 percent of each prescription bill, depending on their income.

It is uncertain how many of the eligible low-income seniors have not applied for the $600 credit, but it's not too late to sign up, said Marilyn Wills, director of the State Health Insurance Assistance Program.

Sierra Health Services Inc., said about 1,500 of its approximately 53,000 Senior Dimensions members qualify for the low-income credit. Senior Dimensions is one of two Medicare Advantage plans available in Nevada and offers more benefits than traditional fee-for-service Medicare, but has a limited provider network.

All of the eligible members were contacted, but only 250 have applied since the beginning of December, said Dave Allazetta, sales manager of Senior Dimensions.

"Why the others didn't respond is a good question," Allazetta said. "Maybe they think the credit is too good to be true."

Senior Dimensions members have some prescription coverage, but the credit will enable them to purchase drugs that may not be on Sierra's preferred drug list, he said.

Medicare beneficiaries must sign up for a prescription drug-discount card and the low-income assistance if they qualify. Those who meet the income requirements and are not on Medicaid, TRICARE military benefits, an employer health plan or a federal employees' health plan can apply.

The deadline for this year's $600 credit is Dec. 31, but Medicare beneficiaries have until March 31 to receive the full $600 credit for 2005. After that, the credit declines by $150 every three months.

Low-income Medicare beneficiaries who sign up for the $600 credit in 2004 are automatically eligible for the $600 credit in 2005.

Medicare beneficiaries are eligible for prescription-drug discounts under the Medicare Modernization Act of 2003, which is a transition phase before prescription drug coverage takes effect in 2006.