Medicare and Sage PLUS, the free State Health Insurance Assistance Program in the Executive Office on Aging, will help people find the best drug card for them out of 39 discount plans available in Hawaii. Sage PLUS volunteer George Hironaka works the hotline.

Isle seniors navigating
Medicare discount card

Officials offer to assist with
a potentially confusing drug plan

Hawaii seniors need to decide in the next few months whether the new Medicare drug discount program "will do them any good," said Mary Rydell, federal Health Care Financing Administration regional administrator in Hawaii.

Those involved with the Medicare Prescription Drug Assistance Program acknowledge it can be bewildering, particularly for people who take a lot of medicine. Previously, Medicare did not offer prescription drug coverage.

But Medicare and Sage PLUS, the free State Health Insurance Assistance Program in the Executive Office on Aging, will help people navigate through 39 discount plans available in Hawaii to find the best card for them. PLUS means "People Learning and Understanding the System."

Overall, the cards are expected to save 10 percent to 15 percent on drugs. However, some can only be used at certain pharmacies; discounts may vary from card to card, and some drugs may not be covered by all the cards.

Card sponsors can change the drugs subject to discounts, as well as the discount prices. But once a card is chosen, it can't be changed until November.

Among the program's many critics is Families USA, which says it has many flaws, requires seniors to make complicated decisions and will give them little or no relief from soaring drug costs.

Kathleen Tamashiro, 69, of Kalihi Valley, said she called the Medicare hot line and received help in choosing a card based on the seven prescription drugs she takes, where she gets them and her income. She's waiting for it to arrive in the mail.

She expects the card to cover all but one or two of her prescriptions and believes she may also qualify for an extra $600 credit for drug cost-savings.

But she said she'll have to compare the Medicare card to drug discount cards she has from Together Rx and People's Benefit to see which is best. She can't use those if she keeps the Medicare-approved discount card, she said.

Rydell said only an estimated 30,000 of Hawaii's 175,000 Medicare beneficiaries are expected to benefit from the drug discount program because Hawaii has "pretty good health insurance coverage."

Many retirement plans already have drug benefits, including those for state, federal and military retirees, she pointed out.

An estimated 36,000 low-income beneficiaries may qualify for a credit of up to $600 in transitional assistance to help pay for prescription drugs if their annual income falls within eligibility limits, she said.

People getting prescription drugs through the Medicaid program aren't eligible for the Medicare cards.

The discount cards must be Medicare-approved and Rydell cautions residents not to deal with any company calling or going door to door claiming to have such a card. "Already on the mainland people are doing just that."

The discount cards aren't required by Medicare and benefits aren't affected if beneficiaries don't sign up for one. But those who have them can start using them Tuesday.

The Hawaii Medical Service Association automatically sent its Medicare-approved drug discount card to 38,000 members of its 65C Plus Basic Option health plan, although those without prescriptions won't need it, said HMSA Senior Vice President Cliff Cisco.

It will be free for the 18-month drug discount period but Medicare allows companies to charge up to $30 a year for the cards, he said.

HMSA 65C Plus members who want another drug discount card must drop out of the health plan, also according to Medicare rules, Cisco said.

Kaiser Permanente isn't offering a Medicare drug discount card because its senior Advantage program provides a 15 percent discount on drugs at Kaiser pharmacies, said Alison Russell, spokeswoman. Non-Advantage Kaiser members over age 65 get a 10 percent discount, she said.

Members aren't prohibited from getting a Medicare drug discount card or a transitional assistance discount card but they can't be used at a Kaiser pharmacy, she said.

In comparing discount cards, Pamela Cunningham, coordinator of the Sage PLUS counseling program, suggested seniors look for the least expensive prices for their medicine and the most convenient pharmacy that supplies their prescriptions.

"Look at the five or 10 (drugs) that are most expensive and see which cards cover the most and give you the most savings," she said.

Only 10 plans may cover all of a person's drugs and maybe only five are at the desired pharmacy, she said. "You keep narrowing things down."

Some people also may find in the screening process that they qualify for the Hawaii Prescription Care Program or the Medicaid Program, Cunningham said.

The process can be overwhelming, she added, "But if you take it piece by piece, it makes it a lot easier, and to know they have help out there, that they're not alone."


Know your needs
before calling

Before you call

>> Callers should know their zip code, be able describe their medicines and doses (such as Lipitor 20 mg., 30 tablets), what they pay monthly for each drug, their choice of a pharmacy or company providing mail-order services, whether they want low-cost or no-cost cards (fees may range from zero to $30 a year), and their total monthly income if they're interested in a $600 credit or other programs to help lower-income residents with drug costs.

>> Cards can be changed only once, between Nov. 15 and Dec. 31, unless the company offering the card stops it or a person moves to another state where it isn't any good.

What to ask

AARP suggests asking these questions about each discount card:

>> Does it provide discounts on each prescription drug you take?
>> How much will the card charge for each prescription?
>> Does your pharmacy accept the card?
>> Can you use the card during travel to other states?
>> Can you use it to get prescriptions through the mail?
>> What is the annual enrollment fee?

For information on the cost of drugs in the different plans, call the Medicare number or the drug discount sponsor.

Where to call for information

>> The Medicare toll-free hotline, (800) MEDICARE (633-4227), or TTY (887) 486-2408, or
>> Sage PLUS, state health insurance counseling program, 586-7299, or toll-free from the neighbor islands, (888) 875-9229.
>> AARP will provide information by telephone, (888) OUR-AARP or (888) 687-2277 or TTY (877) 434-7598.

The Centers for Medicare & Medicaid Services has added 400 customer service representatives to answer calls on its hotline. The best times to call are on Thursdays and Fridays or Sundays. Sage PLUS has 50 trained volunteers statewide who will provide one-on-one counseling and drug card comparisons by telephone or appointment.

Centers for Medicare & Medicaid Services



E-mail to City Desk


Text Site Directory:
[News] [Business] [Features] [Sports] [Editorial] [Do It Electric!]
[Classified Ads] [Search] [Subscribe] [Info] [Letter to Editor]
© 2004 Honolulu Star-Bulletin --