Seniors to start choosing from 71 discount cards

The myriad choices have some seniors nervous and confused.
KNIGHT RIDDER NEWSPAPERS
WASHINGTON -- Medicare's plunge into the world of prescription drug coverage begins in earnest this week, when millions of seniors begin choosing one of 71 government-approved drug discount cards.
The cards offer temporary, albeit modest, relief from high prescription-drug prices until Medicare's full $534 billion prescription-drug benefit begins in January 2006.
On Thursday, Medicare will begin offering help by phone and the Internet -- at (800) MEDICARE, or (800) 633-4227, and www.medicare.gov -- for seniors to figure out which of the cards may be best for them. Medicare is hiring more than 1,000 advisers to be available to answer questions 24 hours a day, seven days a week.
Beginning May 3, enrollees who want the benefit will select from cards offered by HMOs, insurance companies and companies that manage employers' drug benefits. The cards can be used at pharmacies starting in June.
Medicare expects card holders to save 10 percent to 25 percent on their prescriptions, but there are no guarantees, and competing private cards offered without Medicare's approval might offer comparable deals.
Confused by choices
That has many enrollees nervous and confused.
Ruby Enyart, a 73-year-old retired accountant from Amarillo, Texas, said she was bothered that each of the 71 options offered slightly different savings and they had to be carefully compared. "It also bothers me that there's such a multiplicity of offerings," she said.
A recent study found that existing discount cards saved their users an average of about 17.4 percent off retail prices. The Medicare cards are the latest entry into a crowded field of drug discount cards offered by pharmaceutical companies, state governments, pharmacies and other groups.
Medicare officials hope their new entries will provide greater savings because of the competition over some 41 million beneficiaries and the leverage those seniors provide in negotiating discounts with drug companies.
Better savings
Still, some seniors may find better bargains on their own.
For example, David Murrell, a 66-year-old lawyer from Louisville, Ky., said he wouldn't get a card because he could save more by continuing to buy his cholesterol-lowering drugs from Canadian pharmacies.
"Even if I was getting 20 percent off [with a Medicare card], I can still do better in Canada," Murrell said. Having prescription drugs shipped from Canada to the United States is illegal, but the law is rarely enforced.
Medicare enrollees with employer or retiree drug coverage probably will save more on prescriptions through their plans than with the discount cards. Those who participate in state and private discount-drug programs also may find that the Medicare cards won't fetch the savings they now receive.
Only an estimated 7 million low-income beneficiaries who lack coverage are certain to benefit from the cards. When they select Medicare discount cards, they could be eligible for $600 credits on drug purchases and waivers of the cards' annual enrollment fees -- up to $30.
Challenging task
To make the system work, Medicare officials must help seniors determine whether the cards are right for them, and, even before that, inform them of the information they need to have ready when they phone or access the Web site.
"This is going to be a real challenge for all of us," Medicare administrator Mark McClellan told a meeting of state and local health-benefit workers recently. "The scope of these changes and their impact on the lives of 41 million Americans is monumental."
This month, Medicare will mail pamphlets to seniors explaining the program. Television, radio and print ads also are spreading the word.
The information is badly needed because "this rates as one of the most complicated government programs I've ever seen," said Gail Shearer, the health policy director at Consumers Union, a watchdog agency in Yonkers, N.Y. The advanced ages of the applicants, many with vision and cognitive impairments, may make it an especially tough assignment.