Wednesday, November 26, 2003

Drug discounts add to confusion

Seniors skeptical of new Medicare plan

By Tim Bonfield
The Cincinnati Enquirer

Now that Congress has passed Medicare reform, seniors could find themselves at the pharmacy checkout next year shuffling through a pocketful of drug discount cards to figure out which one offers the best deal.

The biggest prescription drug benefits in the $395 billion measure won't kick in until 2006. In the meantime, seniors will be allowed to buy a drug discount card that officials say could cut pharmacy bills by 15 to 25 percent.

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When such a card would be available to seniors and exactly how much it will cost have not been set. However, a yearly fee of about $30 has been discussed.

While looking forward to some serious benefits in 2006 - and a monthly fee of about $35 - seniors and pharmacists in Greater Cincinnati were not impressed by the prospect of yet another weak drug discount card hitting the market.

"It's a disgrace. It will be two years before the benefits really show up. That's after the election and then people will find out it's no good," said Harry Kincaid Jr., a 77-year-old resident of Kennedy Heights. "The discount card? They'll just raise the prices (of drugs) and then say they're giving you a discount."

Seniors already get blitzed with offers from dozens of organizations offering drug discount cards - some from governments, some from associations, others from for-profit services.

There's the TogetherRx card offered by several big drug makers. There's the Ohio Golden Buckeye Card that came out in the past few weeks. There are discounts from AARP, AAA and other groups.

And starting next year, there will be some form of Medicare-issued drug discount card.

"I had a lady the other day with three different discount cards asking me which one was the best," said Tom Mullaney, owner of Mullaney's Pharmacy & Home Health Care in Pleasant Ridge. "Most of these cards offer discounts off a price that nobody pays. In many cases, our regular prices are already lower than what you can get through these cards."

So how are these cards supposed to work?

In Newport, 83-year-old Joseph Buemi stopped by the Newport Drug Center to pick up some prescriptions for his wife. He has a Medicare supplemental plan that offers some drug coverage, but he has to pay a $200 annual deductible and 20 percent of the drug cost.

In theory, the drug discount cards can be used when other health plans don't pay. Buemi pulled a Pfizer "Share Card" from his wallet - but the discounts didn't apply because the drugs weren't made by Pfizer.

So he paid a bill exceeding $70 with his credit card. So next year, will the new Medicare plan help?

What Buemi has heard so far from news reports sounds too complicated, he said.

"If the Medicare card is going to be like the typical discount card, people will find out that they won't save much money," said Bob Crawford, co-owner of the Newport Drug Center.

Many seniors appear unaffected by the new prescription drug benefit plan. They may get drug benefits through a retiree health plan, or still get coverage from the shrinking numbers of Medicare HMOs still doing business, or pay on their own for the most expensive Medicare supplemental plans.

Their biggest concern is whether the new, weaker benefit will prompt employers and insurers to simply drop their current offerings.

"The new plan won't do me much good," said Gerald Blumberg, a 73-year-old resident of Amberley Village. "I have a supplemental plan that takes care of what they're adding on to Medicare."

Unlike Kentucky and Indiana, Ohio offers a drug discount to every Ohio resident person age 60 and older through the Golden Buckeye Card. Unlike the envisioned Medicare card, the state card is free and gets sent out automatically, rather than requiring an application.

Yet in Greater Cincinnati, pharmacists say very few customers are getting significant savings from the Buckeye Card. Some seniors, including Blumberg, haven't even tried to use the new cards.

It remains too early to calculate local usage, but statewide, the program has generated more than 100,000 claims since mid-October, said Gary Panek, program director. People have saved a combined $850,000, he said.

In some places, where competition is high for pharmacies, more than 40 percent of medications are cheaper than the Buckeye Card price. But in other places, seniors are getting savings on more than 95 percent of the drugs they buy, Panek said.

Next year, Ohio officials hope that federal officials will approve rolling the Medicare benefit into the Buckeye Card system to reduce the need for seniors to carry more than one discount card, Panek said.


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