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Medicare Prescription Drug Coverage Changes as a Result of the 2003 Medicare Modernization Act

Starting in 2004, Discount Cards with the Medicare-approved mark will be available for immediate savings on prescription drugs. Medicare will contract with private companies to offer new, voluntary discount cards. A discount card with the Medicare-approved mark offers a discount off the full retail price of prescriptions. Savings are estimated to be 10-25% or more on many drugs.

People with incomes less than $12,124 a year or married couples with incomes less than $16,363 may qualify for $600 to help pay for prescription drugs.

These voluntary cards are being offered for a short time with enrollment beginning as early as May 2004 and continuing through December 31, 2005. People whose drugs are covered by Medicaid are not eligible for this card.

In 2006, the Prescription Drug Benefit will be added to Medicare. All people with Medicare will be able to enroll in plans that cover prescription drugs. People with Medicare will pay a premium estimated to be $35 a month, and there will be a $250 deductible.

  • Medicare will pay 75% of drug costs between the deductible and $2,250.
  • You will pay for drug costs between $2,250 and $5,100.
  • Medicare pays 95% of drug cost above $5,100.

The Prescription Drug Benefit includes additional help for people with low income and limited assets. Most important, people with Medicare who are also fully eligible for Medicaid with incomes below 100% of the federal poverty level (and with no separate asset test) will receive:

  • Full premium subsidy
  • Full subsidy of deductible
  • Minimal co-pays

Other people with low income and limited assets will receive premium and deductible help and have limited cost sharing.

Posted: 12/23/2003

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CPT codes, descriptions, and other data only are copyright 2002 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.

 

 

   
 
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