By Joan W. Lawrence
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Help in understanding the new benefit is available
from Medicare toll-free at (800) 633-4227, or online at www.medicare.gov.
The recent debate over the Medicare Modernization and Reform Act has been so politicized that it is difficult for some to understand the changes to the single most important government program for seniors. This is ironic, since it's seniors for whom Medicare was modernized.
We hope the fog begins to clear as the initial benefit - Medicare-approved discount cards - is fully explained by the 28 companies Medicare has permitted to market in Ohio.
The need for prescription drug assistance has been illustrated in stories about seniors skipping pills or splitting them, quarterly pilgrimages to Canada and the Hobson's choice of food or prescriptions. According to a recent study (Kaiser/Commonwealth/Tufts-New England Medical Center), 22 percent of older Ohioans have no insurance coverage for their medications. That's 331,000 Ohio seniors - many living on modest incomes. The Medicare prescription drug benefit will help many of these seniors buy the medicines they need.
We know for sure that seniors getting by on small pensions or monthly Social Security checks totaling $1,000 to $1,500 (depending upon their marital status) will benefit the most. For them, the new Medicare prescription discount card will be free and offer a $1,200 drug credit from June 2004 through December 2005.
For others, the decision to purchase a drug discount card requires consideration. Companies can charge as much as $30 for the cards, and the discounts will range from 15 to 25 percent off the cash price a person with no insurance would pay at a pharmacy.
Anyone thinking about a Medicare-approved card should consider what a new card would offer them that their free Golden Buckeye Card does not. Golden Buckeye Cards are already saving users more than $1 million a month - an average of 24 percent each time the card is presented at the pharmacy. If you don't have a free Golden Buckeye Card, get one by calling toll-free (866) 301-6446. Seniors should also find out if they qualify for individual Pharmaceutical Company Patient Assistance Programs. Savings may be even greater in such programs.
In any case, seniors should choose their Medicare-approved discount card carefully, since they may have just one Medicare-approved card. However, they may have any number of other drug discount cards.
The new Medicare drug benefit is a comprehensive drug coverage policy for all Americans 65 and older. Those with lower incomes will pay little for their prescriptions, but many will benefit from the program. Medicare prescription drug plans are voluntary. Many seniors require multiple, expensive maintenance medications, and they will view this new benefit as a real lifesaver.
For those who needn't rely on prescription drugs to maintain a high quality of life and independence, other new Medicare preventive health benefits include a one-time wellness physical exam after you first enroll in Medicare Part B, and blood tests to detect heart diseases and diabetes early.
So, as the stories spin about the new Medicare reform, let's not forget that Medicare is first and finally about seniors. It's not about who gets credit for the most significant change in Medicare since its creation 40 years ago. It is about helping seniors with their No. 1 concern - affordable prescription drugs.
Joan W. Lawrence is director of the Ohio Department of Aging.
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