Preface:   There are many ways for seniors and others to save money on prescription drugs. These include the EPIC program, discount pharmacies, pharmaceutical manufacturers' patient assistance programs (<www.NeedyMeds.com>), drug manufacturers' discount cards, as well as the new Medicare Approved Drug Discount Cards. All of these options are voluntary, so you can choose programs that best meet your own needs. We encourage you to thoroughly explore your options. Information is provided below on the new Medicare Approved Drug Discount Cards and the EPIC Program for New York State seniors.

Medicare Approved Drug Discount Cards

What are they?  

     These are plans offered by private companies or organizations, approved by Medicare, that provide discounts on prescription drugs for Medicare recipients. This is a voluntary program, so you can choose whether or not you want to apply for one of these cards. You are not eligible to purchase a card if Medicaid covers all your prescription costs.

  •  A drug discount card is not health insurance; if you already have insurance with prescription drug coverage, Medicare advises you not to drop your coverage for a drug discount card.

How do I know if a drug discount card is approved by Medicare?

       At least 28 companies or organizations have been approved. The approved cards will have a special seal that is shown at right. Look for this seal.  

How much will I save?

    It depends on your income and the card you choose.  

•  If you are a single person on Medicare, and your annual income for 2004 is greater than $12,569, or a married couple with an income greater than $16,862, you will be charged a fee for the discount card of up to $30 a year. Remember, fees will vary with the company chosen, but you cannot be charged more than $30 per year. When you buy your prescription drugs, your discount will vary depending on the pharmacy, the drug, and the card you purchased.  

      Although the government predicted that discounts would reduce drug costs for Medicare recipients from 10% to 25%, in reality, consumers are not finding that to be true yet. Compared to discount and online pharmacies, some prices at the outset of the program were actually higher with the discount drug card. Companies are adjusting prices because of this, and many errors have also been discovered, so consumers are being advised to wait a few weeks before deciding on a card.

•  If you are on Medicare and your annual income for 2004 is lower than the amounts described above, you may qualify for a $600/year credit that will help pay for your prescription drugs. This credit is available for 2004 and another $600 credit will apply in 2005.  

       To get this credit, you would apply for an approved drug discount card that is available in your area, and also fill out an enrollment form for the $600 credit. If eligible for the credit, you would not have to pay any fee for the drug discount card. Then, for each prescription drug purchased, you would pay a small amount (called a co-pay), and the rest of the cost would be deducted from the $600 credit.

      If you are already enrolled in EPIC, New York State's Prescription Drug Program, and your income qualifies you for the $600 credit, you do not have to apply separately for the credit or drug card. EPIC will automatically enroll you into their discount card option with First Health and you will be eligible for the $600 credit. Having EPIC will reduce your copayments for prescription drugs even further than if you only had the approved drug discount card.

How do I choose between all the competing cards I've seen advertised?

       Choose carefully, since only one Medicare-approved discount drug card can be purchased per calendar year in most cases. Because there are such differences in pharmacy prices, as well as cards, Medicare has provided a website for more information and for calculating your savings with different discount drug cards, <www.Medicare.gov>.   By providing the names of the drugs you purchase and your location, you will be able to see what your cost would be with different cards that are available to you. Drug prices on the website will be updated weekly. If you have no computer, you can get this information by calling 1-800-MEDICARE (1-800-633-4227).  Another source of up-to-date consumer information can be found at the Medicare Rights Center's website, <www.medicarerights.org>.

           It is important to realize that only drugs that are listed on the company's discount drug list will be discounted. Different drugs may be discounted at different rates and, in addition, the company has the right to change the discount drug list and the amount of the discount. Therefore, the discounts that you sign up for may not be available for the entire time you are enrolled. Check to make sure the pharmacy you use will accept the drug card you are considering. Remember that you do not have to purchase one at all . Seniors should also investigate their eligibility for the New York State-sponsored EPIC prescription drug program described below.

     In Tompkins County, more information is available from the Office for the Aging at 274-5482. One-on-one assistance from trained counselors can be obtained by calling the Senior Citizens Council at 273-1511.                                 

 The EPIC Program

     The EPIC Program is a New York State-sponsored prescription drug plan for seniors. It is available to New York residents 65 or older, whose income is $35,000 or less if single, and $50,000 or less if married. EPIC helps reduce the cost of prescription drugs with a cost sharing approach. They have two plans with eligibility based on income.

1)   The first, called the Fee Plan, is for single seniors with income up to $20,000, and married seniors with income up to $26,000. They would pay an annual fee based on income to join the plan. Then, for each prescription, they would have a co-pay based on the cost of the prescription, ranging from $3 to $20.

•     Seniors with incomes of less than $12,569 for a single person or $16,862 for a married couple, could see significant savings by enrolling in EPIC. The EPIC program will automatically enroll them in a Medicare-approved drug discount card and apply for the $600 Medicare credit. They would pay no fees for the EPIC card or the drug discount card, and their co-pay would be reduced because of the portion that would be paid by the Medicare credit. If a senior is already enrolled in EPIC, they will be automatically enrolled in a Medicare-approved drug discount card that coordinates with EPIC.

2)   The second plan (Deductible Plan) is for single seniors with incomes of $20,001 to $35,000, and married seniors with incomes between $26,001 and $50,000. They do not pay any annual fee, but would have to meet their annual deductible, based on their income, before receiving any benefits. Once their deductible is met, they would pay only a co-pay of $3 to $20 per prescription, based on the cost of the prescription.

•      If a senior is already enrolled in the EPIC Deductible Plan, they could still enroll in a Medicare approved drug discount card, but the prescriptions purchased with the discount card would not be counted toward their EPIC deductible. They would have to choose which plan to use with each drug purchase.

        To see the fees and deductibles associated with the EPIC Program and get an application, go to the Department of Health website at < www.health.state.ny.us > and click on EPIC for Seniors, or call 1-800-332-3742. Information and one-on-one assistance can also be obtained by calling the Tompkins County Senior Citizens Council at (607) 273-1511 or the Tompkins County Office for the Aging at (607) 274-5482.

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