Initiative to help Medicare beneficiaries

AUGUSTA – Gov. John Baldacci has announced a statewide initiative to assist Medicare beneficiaries in accessing the new Medicare Drug Discount Card and to coordinate with similar programs in Maine.

According to Baldacci, Medicare beneficiaries have begun receiving information from the Social Security Administration about how to sign up for the discount card program that begins this June. MaineCare members are not eligible for the card. However, those who participate in Drugs for the Elderly and Maine Rx Plus are eligible.

“We want to help Maine’s Medicare beneficiaries effectively coordinate benefits and are particularly concerned for those on Drugs for the Elderly – a program designed to provide benefits for Mainers with no other source of coverage or who have exhausted other coverage,” said the governor.

To qualify for the Medicare Drug Discount Card, Medicare members must select from among 39 different companies called card sponsors. Each sponsor will offer its own list of covered drugs and discounts, which will be subject to change. Medicare members select the sponsor they prefer, pay $30 for their card and qualify for discounts.

Medicare members with incomes at or below $12,569 for a person, or $16,862 for a couple, qualify for a transitional benefit in which the federal government pays the $30 enrollment fee and provides a $600 benefit for prescription purchases.

Those receiving transitional assistance pay nominal co-pays, ranging from 5 to 10 percent of the cost of the drug, of the cost of the drug, based on income.

To coordinate the Drugs for the Elderly and the Medicare Transitional Assistance Benefit, the Maine Department of Human Services will select one of the 39 card sponsors as a partner.

A request for proposals was released recently to all sponsors. The DEL Medicare Preferred Discount Drug Sponsor will work with DHS to assure DEL members first use their $600 Medicare benefit. The state’s Drugs for the Elderly program will begin paying once the person uses up the $600 Medicare benefit.

DEL members will soon receive a letter from DHS urging them to hold off selecting a card sponsor for their Medicare Drug Discount Card until a Preferred Sponsor is available later in May.

“By authorizing DHS to enroll you in a Preferred Sponsor,” said Baldacci, “the program will coordinate benefits on your behalf. Medicare beneficiaries need not select a sponsor immediately since the Medicare Drug Discount does not begin until June.”

DEL members may choose a different card sponsor and track their own expenses to assure DEL does not pay costs that could have been covered by Medicare.

Any DEL member who does not want to be automatically enrolled with DEL’s Preferred Sponsor will receive a form to return to DHS to notify the Department of that choice. All others will be automatically enrolled and expenses automatically tracked.

Baldacci praised DHS for moving quickly to simplify and streamline program coordination immediately upon learning of the Federal government plans.

“DHS, working with consumer organizations, Legal Services for the Elderly and the area agencies on aging, is prepared to help address questions and concerns about the new Medicare Drug Discount Program and its coordination with DEL and Maine Rx Plus,” said Baldacci.

The Medicare Drug Discount Program will be available for 18 months, when the comprehensive Medicare Drug program begins.

Medicare beneficiaries can receive more info from Medicare toll free at (800) 633-4227; Maine Department of Human Services toll free (866) RxMaine (796-2463) or by calling their area agency on aging, 941-2865.