Medicare cards for Nevada seniors explained

Michelle Swafford

Monday, May 3, 2004 | 9:48 a.m.

Beginning today, people who are eligible for Medicare can begin signing up for prescription drug discount cards as part of a new benefit that takes effect in June.

There are 38 Medicare-approved discount cards and a host of other discount cards aimed at helping people ages 65 and older with their drug costs. The cards offer an average discount of between 10 percent and 25 percent on drugs and vary in their annual membership costs.

Medicare beneficiaries can compare discount programs based on their drug needs at the Centers for Medicare and Medicaid Web site, www.medicare.gov.

The Web site shows that in Las Vegas, arthritis pain reliever Celebrex (10 mg for 30 days) costs between $49.81 with the PrescisionDiscount card at a Kmart pharmacy and $87.87 with the RxSavings card at Sav-on Drugs.

Depending on the discount card, Celebrex prices vary by as much as $30 at Kmart.

Nevada's regional director for the Centers for Medicare and Medicaid Services was in Las Vegas on Thursday to answer questions about the discount cards.

H. Stephen Deering, deputy regional administrator for the San Francisco regional office of CMS, said although Medicare wasn't designed as an all-inclusive health plan, seniors will begin seeing additional health benefits such as the drug discount cards and coverage for preventative exams and disease management as part of the Medicare Modernization Act.

There are approximately 10 million Social Security recipients who lack drug coverage and the drug cards will help with their monthly drug costs, Deering said.

Anyone on Medicare except those who receive Medicaid coverage can sign up for a drug discount card.

Medicare + Choice plan members will have their own insurer-provided cards instead of the traditional Medicare discount card, but those members can sign up for discount cards not approved by Medicare for savings on drugs not discounted through their plans.

Deering said funding increased for insurers that offer Medicare + Choice plans, now called Medicare Advantage, which will provide additional benefits and larger reimbursements for physicians.

Locally, Las Vegas-based Sierra Health Services Inc. and Cypress, Calif.-based PacifiCare Health Systems Inc. provide such plans and both companies have lowered monthly premiums and co-payments and added benefits to their plans.

Las Vegas resident Phyllis Schuster attended Thursday's CMS presentation and said she thinks the program will be helpful to seniors.

"The prescription plan is great, especially if you can take advantage of it," she said.

Schuster learned at the presentation that she is not eligible for the discount cards because she receives state assistance.

Critics of the discount cards such as Washington, D.C.-based consumer organization Families USA said the cards won't provide true savings to seniors and are too complicated.

"With drug costs continuing to skyrocket, this program is like a used car salesman offering a $3,000 discount after the sticker price was increased by $4,000," Families USA Executive Director Ron Pollack said in a statement.

Deering said the drug discount cards were designed as a transitional program that runs through Dec. 31, 2005. Beginning January 2006, Medicare beneficiaries can sign up for drug coverage with a $35 monthly premium and a $250 annual deductible as part of their Medicare coverage.

With the drug coverage, Medicare will pay 75 percent of the drug costs and the beneficiaries will pay 25 percent up to $2,250 in expenses. After that, Medicare recipients are responsible for all drug costs until $5,100 has been incurred in drug costs, or $3,600 in their out-of-pocket drug costs. Medicare will then pay 95 percent of the drug costs.

Although signing up for drug coverage is optional, there will be a penalty for people who sign up after a certain time period, Deering said.

A 10 percent per month penalty exists for Medicare beneficiaries who don't sign up within a few months of being eligible for Medicare Part B, which covers medical tests, equipment and emergency care, he said.

"It's insurance," Deering said. "We have people saying, 'I'm not sick. I don't need it,' and they get sick. You want people signing up as a preventative measure."

Other additions include a preventative wellness exam after signing up for Medicare and a screening for heart disease and diabetes, all of which will be available in January.

In January 2007, Medicare will charge some beneficiaries a greater percentage of their premiums for their Part B, or medical, premiums.

The premium will be based on a sliding scale that will charge those Medicare recipients who have an annual income of $80,000 for individuals and $160,000 for couples 10 percent more than others, Deering said.