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What's New? ElderCare Q&A New $600 Drug Benefit 5/1/2004 - Q: What's this new $600 drug benefit Medicare is offering seniors? A: The Transitional Assistance Program (TA) is part of the new Medicare modernization law passed in December. The law creates temporary discount drug cards and the TA benefit, both of which start June 1st. Medicare will provide a $600 drug credit in 2004 for a single person with annual income up to $12,569 ($16,862 for a couple). If your income is at the poverty level ($9,310 for one person, $12,490 for a couple), you will pay a 5% copayment at the drugstore for your medications. If your income is above the poverty level, but still qualifies you for TA, you will have 10% coinsurance to pay. To get the $600 benefit, you must have a Medicare-Approved Drug Discount Card. But for those people whose income qualifies them for the $600, Medicare will cover the $30 annual fee for the discount card. To qualify for the $600 benefit, you must not receive drug coverage from other sources, including Medicaid or group health insurance, except if your drug coverage is through a Medicare HMO plan or a Medigap supplement plan. You must sign up for a discount drug card and the $600 credit at the same time. You will have to submit income, retirement and health benefits information. You'll be able to use your discount card and $600 to buy medications the first day of the month following your application approval. You can only enroll in one approved discount card at a time, and you can only change cards once, between November 15th and December 31, 2004. If you move out of the discount card area, switch your Medicare health plan, or go in or out of a nursing home, you can also switch cards. All discount cards offered in Massachusetts must cover the whole state. Most prescriptions purchased at retail pharmacies are eligible for discounts and the $600 credit. Syringes and medical supplies for insulin injections are covered. If a card uses a formulary of specific discounted drugs, they must include the most commonly needed drugs for Medicare beneficiaries. The $600 cannot be used to purchase over- the-counter drugs. If an elder does not use up their full $600 credit in 2004, the unused portion will rollover to 2005, and a second $600 benefit will be added. The program will end at the start of 2006. A website will allow people with Medicare to compare prices, fees, and other card program features. Go to www.medicare.gov/" or call 1-800-MEDICARE. The website offers a Guide to Choosing a Medicare-Approved Drug Discount Card. The Medicare program has selected 28 card sponsors, plus 84 Medicare managed care plans which will offer cards to their members only. Massachusetts officials have said they will encourage everyone in the state-run Prescription Advantage plan to sign up for the $600 TA benefit. To find out what cards are offered in Massachusetts, and how to enroll for the $600 credit, call the SHINE program at 1-800-Age-Info, press 2. Back to What's New?
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