Drug Discount Card Baffles Some Seniors

Just off a crosstown freeway in a neighborhood of boarded-up row houses, the Lakeview Towers public housing project could be a poster location for the Medicare drug discount card that takes effect today.

The 305-unit, twin-tower complex is home to 220 seniors and disabled persons, virtually all of them qualified for Medicare or Medicaid. Even with federal subsidies holding down rents to a median $215 a month, many of the residents struggle to pay for their prescription drugs.

Bush administration officials say the drug discount card would save Medicare-eligible residents from 10% to 18% on brand-name drugs and from 30% to 60% on generics until 2006, when the government’s Medicare prescription drug subsidy kicks in. Many low-income seniors at the complex qualify for an even better deal: a $600 annual subsidy plus substantial savings from some drug manufacturers for individuals who earn less than $12,569 a year and couples who make less than $16,862.

But days before the discount card was set to take effect, no one among 10 Lakeview seniors gathered in the lobby of the complex had enrolled in the program.

None of seniors had received materials from the government or promotional mailings from private card sponsors explaining the program. They were eager to learn more about the card but said they didn’t know the government’s toll-free information number and didn’t have access to the Medicare website. No one had come to the complex to tell residents about the discount card, they said.

“I wish they would,” said Rhonda Van Dyke, Lakeview’s manager. “For most of our residents, this would really help.”

Since the administration rolled out the Medicare discount card -- the first major benefit of last year’s landmark Medicare law -- it has been a flashpoint for political debate.

Democrats and some consumer groups have produced studies showing that seniors could save more money by shopping around on the Internet or buying their prescription drugs from Canada.

Even many Republicans, seniors’ groups and private card sponsors acknowledge that the enrollment process, which requires seniors to choose from among 40 national cards and some of the 33 regional ones, is cumbersome and confusing.

Yet nearly everyone, including the harshest critics of the new Medicare law, agrees that the $1,200 low-income subsidy -- $600 this year and another $600 in 2005 -- would make the discount card a sure-fire winner for most of the 7.2 million poor seniors believed to be eligible.

Seven states -- Connecticut, Maine, Massachusetts, Michigan, New Jersey, New York and Pennsylvania -- are automatically enrolling seniors who participate in their state pharmacy assistance programs.

But if the residents of Lakeview Towers are representative of low-income seniors elsewhere, government agencies and private groups that have pledged to enroll eligible seniors have a lot of work ahead of them.

The Health and Human Services Department announced Thursday that it would spend an additional $4.6 million on public and private outreach efforts to low-income seniors. That’s on top of $21 million already funneled to state health insurance programs, which offer counseling to Medicare beneficiaries.

James P. Firman, chairman of the Access to Benefits Coalition, a network of 68 nonprofit groups working to tell low-income seniors about the discount card, welcomed the federal funds but said new strategies, corporate partnerships and still more money would be needed to achieve the coalition’s goal of enrolling 5.5 million poor beneficiaries by the end of next year.

“Most public benefits outreach efforts until now have been to find needles in a haystack,” said Firman, who also is head of the National Council on Aging. “We believe the challenge is to find the stacks of needles.”

Lakeview Towers surely is one of them.

Earlene Smooth, 76, takes six prescription drugs for hypertension and diabetes. “If it wasn’t for my children helping me sometimes, I wouldn’t get my medicine,” she said.

But the bespectacled widow, sharply dressed in a lime green sweater, floral-print skirt and white moccasins, said she did not plan to sign up for the discount card.

“I read about it but I don’t understand it,” she said. “They tell you to go on the computer, but everybody doesn’t have the computer. There’s no way to really find out what’s better for me. The government should really have a plan you can understand.”

For now, Smooth will stick with Maryland’s state pharmacy discount program. For a $10 monthly fee and co-payments of $10 to $40 per prescription, she receives subsidies totaling up to $1,000 a year -- $1,000 “is nothing,” she said -- for her six medications.

Smooth and some other Lakeview residents who participate in one of Maryland’s two pharmacy assistance programs received a letter from the state in April outlining the new Medicare benefits and advising them to decline them for now because they would have to give up the state program.

“Many prescription discount card companies will try to enroll you in the Medicare drug discount card program,” read the letter from Joseph E. Davis, eligibility director of the Maryland Department of Health and Mental Hygiene. “Do NOT sign-up for the Medicare discount prescription card. You already receive higher savings with your State pharmacy benefit.”

Bill Pierce, spokesman for the Health and Human Services Department, said federal officials were unaware of the Maryland letter and did not know if other states were advising low-income residents to turn down the Medicare discount card.

Firman, whose Access to Benefits Coalition will soon release a state-by-state guide to drug benefits for seniors, confirmed that one of Maryland’s pharmacy assistance programs was better for seniors than the Medicare card. But many seniors have incomes or assets too high to qualify for the state programs, “and they should get the Medicare card,” he said.

Lakeview resident Gloria Bennett takes 14 medications a day for a range of ailments. The 73-year-old, who calls the new Medicare law “a joke,” is dissatisfied with the generics she sometimes gets through the state program. Bennett pays just $7.50 apiece for most of her medications, but recently she has had to pay $101 for a month’s supply of the acid reflux medicine Nexium -- and she can barely afford that. So she wants to learn more about the Medicare discount card.

John H. Robinson, 71, fished his worn Medicare card out of his pocket and said he got no help in paying for his prescriptions. “I pay across the board, $287 a month,” he said, for three prescriptions for his heart, blood pressure and kidneys.

Robinson, who lives on Social Security, probably would qualify for the Medicare card’s low-income subsidy but doesn’t know how to get it. “I heard something on the TV,” he said, “but no one’s told me about it.”