MEDICARE DISCOUNT CARD
by  Dr. Randall M. Suzuka
2004

The Medicare Modernization Act of 2003 (MMA) created a Medicare prescription drug benefit.  Unfortunately, this benefit does not start until January 2006.  In the mean time, the MMA has a transitional plan with two components: 1)  $600 credit for medication for those who qualify, 2) Medicare discount card for everyone with Medicare.  You can only get one discount card.  Each discount card has different participating drug companies or pharmacies so you should check it out first before signing up to see which card, if any, would be most beneficial to you. 

$600 Credit.   This is available if you make less than $12569 each year for an individual or $16852 each year as a married couple (the information says that if you live in Hawaii or Alaska, income limits are different).  If you qualify, not only do you get a $600 credit for your medications each year, you also will not have to pay the enrollment fee for the discount card. You do not quality for the $600 if you already have outpatient drug coverage from certain other sources.  To get the $600 credit, all of the following must apply:

• You have Medicare Part A and/or Part B.
  

• You don’t have other health insurance with any outpatient prescription drug coverage (except a Medicare + Choice plan or a Medigap policy.
  

• Your annual income in 2004 is no more than $12569 if single, $16862 if married (different for Hawaii and Alaska).

You cannot get the $600 credit if you have outpatient prescription drug coverage from any of the following:

• Medicaid.
  

• TRICARE for Life.
  

• Employer group health plan or other health insurance coverage including some Medicare Managed Care plans (other than a Medicare + Choice plan or Medigap policy).

Medicare Discount Card.    You can get a Medicare Discount card if:

• You have Medicare Part A and/or Part B.
  

• You don’t have outpatient prescription drug benefits through Medicaid.

Some important points:

• You can only have one Medicare-approved drug discount card at a time.
  

•  There may be an enrollment fee of up to $30 (one time fee).
  

•  Only the drugs included on the card’s discount drug list will be discounted.  It is important to see if your medicines are covered on the card that you choose or ask your doctor if there is an alternative that would be covered.  For medications not on the list, you will pay full price.
  

• If your Medicare Managed Care plan offers a discount care to its plan members only, you must choose that card.  If your Medicare Managed Care plan doesn’t offer a Medicare-approved drug discount card, or offers a discount card that is open to non-members, you can choose any discount card offered in the state.

How To Get Started

If you have internet access, here are some helpful resources:

• http://www.medicare.gov
  

•  http://www.medicare.gov/Assistance Programs/home.asp
  

• Introduction   http://www.medicare.gov/Publications/Pubs/pdf/11060.pdf
  

• Guide to Choosing a Medicare-Approved Drug Discount Card      http://www.medicare.gov/Publications/pubs/pdf/11062.pdf
  

• Medicare-Approved Drug Discount Card Tip Sheet          http://www.medicare.gov/Publications/Pubs/pdf/11071.pdf
  

• Enrollment tip sheet   http://www.medicare.gov/Publications/pubs/pdf/11076.pdf

Call 1-800-633-4227 or for TTY users 1-877-486-2048.  Get help from SagePlus 586-7299 if needed.

Editor: Dr Randall M. Suzuka is a graduate of the John Burns School of Medicine. He can be contacted at 637-5087 or by email.