Oregon Department of Justice

The US Congress has passed a new Medicare Law that changes the way older Oregonians will receive benefits and be able to pay for their prescription drugs. Oregon Attorney General Hardy Myers is concerned that older citizens may not receive all the information and resources they need to make the best choices as they deal with these changes in the law.

The new law includes prescription drug discount cards that will be available for purchase on May 3, 2004, although the cards will not be effective until June 1, 2004. The Medicare Program is endorsing certain discount cards as a way to achieve savings but these cards may not be right for all older consumers and Medicare beneficiaries. Attorney General Myers is encouraging older consumers to study all their options with friends and family before purchasing one of these cards.

The prescription drug discount cards are expected to provide savings of 10-25 percent off retail prescription drug prices, with additional assistance available for low-income beneficiaries.

The discount cards will be offered by private businesses and organizations. The Medicare program will only approve discount cards that meet certain standards, such as providing a range of different categories of discounted drugs, access to local pharmacies, and regular price comparisons for discounted drugs. While companies offering Medicare-approved discount cards can charge an annual fee of up to $30, about 25 percent of the companies will not charge any fee.

Since Medicare beneficiaries can purchase only one Medicare prescription drug discount card, older Oregonians are cautioned to study each feature carefully. The following questions should be asked before purchasing the discount cards:

• Is the card approved by Medicare? (The list is included in this article.)
• Does this card cover the drugs I take?
• Does this coverage ever change and how often?
• How much money can I save using this card? (Calculate this by listing your monthly drug costs and calculate the savings the card would offer on each drug. Add it up and compare it to your current monthly bills for drugs.)
• Does the pharmacy where I shop accept this card? Ask your pharmacist-do not rely on the literature from the card provider.

The following is a list of Medicare-approved card sponsors who will be offering prescription drug discount programs to Medicare recipients throughout the nation. Two Medicare managed care plans, Health Net Life Insurance Company and PacifiCare of Oregon, Inc., are approved to offer regional cards in Oregon.

• Aetna Health Management LLC
• Caremark Advantage Inc.
• Catalyst Rx
• Medco Health Solutions Inc.
• PMB Plus Inc.
• PharmaCare Management Services Inc.
• Pharmacy Care Alliance Inc.
• Scrip Solutions LLC
• SXC Health Solutions Inc.
• United Healthcare Insurance Co. (with AARP)
• WellPoint Pharmacy Management
• Express Scripts Inc.
• Argus Health Systems Inc.
• Computer Sciences Corp.
• WHP Health Initiatives Inc.
• AdvancePCS Health LP
• First Health Services Corp.
• Long Term Care Pharmacy Alliance LLC

Any prescription drug discount cards available for purchase before May 3, 2004 have NOT been approved by Medicare and are not under federal regulation. Older Oregonians should be especially careful when buying cards not on the approved Medicare list because they may or may not meet the same standards as those on the Medicare-approved list.

Many organizations are currently offering prescription drug discount cards. They are advertised on television, in the newspapers, through the mail and over the Internet. Some of these cards are offered by established, familiar organizations such as pharmaceutical manufacturers, pharmacy chains, advocacy organizations, and pharmacy benefit managers. And some cards are offered simply as a business venture. Consumers should note that cards being sold door-to-door are NOT approved by Medicare.

• Purchase a non-Medicare discount card only from a known and trusted company or organization.
• Compare the costs and benefits of several cards before purchasing one. The costs and benefits may vary widely.
• Prescription drug discount cards shouldn't cost more than $30 unless it provides significant additional benefits such as dental care or eyeglasses.
• Read the fine print before you purchase anything.
• Be cautious about giving out personal information such as your social security number or mother's maiden name. Never give out your bank account number or your pin numbers or passwords.
• Keep a record of the organizations name, address and phone number. Keep copies of all information provided the company.
• When you receive medication through the mail or from a pharmacy, always check to see if it is exactly what you ordered. If you have concerns, call your doctor.
• If you believe that a discount card company's sales practices are unfair or deceptive, call the Attorney General's consumer hotline at (503) 378-4320 (Salem area only), (503) 229-5576 (Portland area only) or toll-free at 1-877-877-9392. The Oregon Department of Justice is online at www.doj.state.or.us.

The new Medicare law also created a benefit that will provide prescription drug insurance to Medicare beneficiaries. This benefit will be available beginning January 1, 2006. The federal government is still working out the specifics and Congress may still make changes in this benefit before it is put into place. Watch for information from Medicare.

Starting later this month, beneficiaries will be able to compare prices of drugs offered by the drug card programs online at www.medicare.gov or by calling 1-800-MEDICARE. Additional information on the new law and benefits is available to Oregon seniors by calling the Centers for Medicare and Medicaid Services at 1-800-633-4227 or online at www.cms.hhs.gov.