• Medicare Prescription Drug Discount Programs

Overview: The Medicare Prescription Drug Discount Card and Transitional Assistance Program was enacted into law on December 8, 2003 as part of the Medicare Modernization Act of 2003. The Administration worked with Congress to provide this voluntary program to give immediate relief to people with Medicare to help reduce their costs for prescriptions before the new drug benefit is implemented on January 1, 2006.Today, seniors and persons with disabilities without drug coverage pay some of the highest prices for prescriptions, sometimes as much as 20 percent more than those with coverage. The Medicare Prescription Drug Discount Card Program will enable Medicare beneficiaries to obtain discounts of 10 to 25 percent on prescription drugs.As early as May, people with Medicare, except for those with Medicaid drug coverage, will have the opportunity to enroll in a Medicare-approved prescription drug discount card to help lower their drug costs.

Medicare Prescription Drug Discount Programs

Beginning this June, these cards will provide discounts off the regular cash price of prescriptions. These cards will primarily benefit individuals without outpatient prescription drug insurance. This program is not intended to be a prescription drug benefit, but rather a measure to help people until the drug benefit is implemented on January 1, 2006. In 2004, 7.3 million people with Medicare are expected to enroll in the program, and save between $1.4 billion and $1.8 billion in discounts on their prescriptions.Medicare will provide a $600 credit for the purchase of prescription drugs in 2004 and up to an additional $600 credit in 2005 to people with incomes that are not more than 135 percent of the poverty line ($12,569 for single individuals or $16,862 for married individuals in 2004 – these income levels will vary slightly for subsequent years) if they do not have certain other drug coverage. Medicare will work with card sponsors so the funds are administered accordingly.

Of the 7.3 million expected to enroll in the discount drug card program, an estimated 4.7 million are expected to apply for the $600 credit and save an estimated $2.4 billion, in addition to the savings from the discounts.When applying the $600 credit toward the purchase of prescription drugs, beneficiaries who have incomes at or below 100 percent of poverty ($9,310 for individuals or $12,490 for couples) will pay 5 percent coinsurance and those with incomes between 101 and 135 percent will pay 10 percent coinsurance. On average, Medicare beneficiaries without drug coverage will pay about $1,400 in 2004, so the discounts and $600 in assistance will be of substantial help them.Starting April 29, 2003, CMS will provide at and through 1-800-MEDICARE, information about drug prices offered by the Medicare-Approved Drug Discount Card Program, and other pharmacy assistance programs and opportunities. This information will be available to help people choose the card that best meets their individual needs.Card sponsors can charge up to $30 per year for enrollment. Medicare will pay enrollment fees for those who qualify for the $600 subsidy.

Additionally, Medicare will ensure that at least two choices of discount drug cards are available in the 50 states and the District of Columbia.

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