Workshops clarify complex Rx plans for professionals

The complexity of discount prescription programs is enough to send cost-conscious consumers into a tailspin.

MaineCare, Maine Rx Plus, Drugs for the Elderly and Disabled, and, coming May 1, the federal Medicare-Approved Drug Discount Card – who can sort it all out?

Workshops offered statewide in the next few weeks aim to bring professional counselors and advocates up to speed on how to help confused consumers link up with appropriate prescription programs.

Three nonprofit groups – Maine Legal Services for the Elderly, Maine Equal Justice and the Maine Primary Care Association – are banding together to offer the two-part program in five cities statewide.

The Medicare benefit, contained in an intricate, 700-page law, is hard to understand and harder to explain.

For one thing, it’s still something of a moving target. MLSE director Paul Lavin said Thursday that eleventh-hour details are still being worked out in Washington, along with the Internet-based application process.

“People are just beginning to wrap their arms around how the Medicare plan is going to work,” he said.

Basically, eligible Maine residents will have to choose one of about 20 different state-specific cards, each of which will discount a selected group of drugs by 10 to 15 percent.

Or they can select a regional or national card.

Consumers, or their advocates, will need to research the cards, which will be offered by private insurance companies, to determine which will provide the greatest benefit for the specific drugs they take.

Low-income Medicare members may qualify for $600 of free medications, but only if they sign up within a certain timeframe.

And not all drugstores will accept all the cards, or any of the cards. Wal-Mart, for example, has said its pharmacies will not participate in the Medicare plan, period.

For some people, including seniors, Maine Rx Plus or the state’s Drugs for the Elderly program may offer a better deal, Lavin said – especially considering that the card program ends in 2006 when the “real” Medicare benefit kicks in with a whole new set of rules and regulations.

The more advanced, morning session of each daylong educational workshop will target counselors, social workers and other professionals involved in assisting seniors and other consumers with health care choices.

The two-hour afternoon session is more basic, designed for those who provide general assistance through volunteer programs and other services. Lavin said interested consumers and community members may attend as well, but space in both sessions is limited.

“This is not really about what consumers need to know,” Lavin said. “It’s more what providers need to know to help consumers.”

A grant from the Maine Health Access Foundation, created by the 1999 sale of Maine Blue Cross and Blue Shield to Anthem Insurance, is supporting the workshop project.

Lavin said he knows of no other provision for educating the professionals charged with advising consumers on the different plans and how they relate to each other.

“Everything You Need to Know about Drug Coverage Options” will be offered 9 a.m.-noon and 2-4 p.m. Wednesday, April 28, at the Bangor Public Library on Harlow Street.

In Caribou, the workshops will be held at the same times on Friday, April 24.

Workshops also will be held in Portland, Augusta and Lewiston-Auburn.

For more information or to register, contact Pat Edwards at Maine Legal Services for the Elderly at (207) 621-0087.