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MMA 2003

The New Medicare-Approved Drug Discount Card Program Can Help Some People Living in a Nursing Home Save on Prescription Drugs

In 2004 and 2005 people with Medicare can sign up for a Medicare-Approved Prescription Drug Discount Card. Low-income Medicare beneficiaries who do not have Medicaid outpatient drug coverage may qualify for a $600 credit in each year. The drug card and the $600 credit are designed to help people who are paying out of pocket for their prescription drugs. The card sponsor and your pharmacy will know when to apply the $600 credit. The $600 credit cannot be used if Medicare Part A is paying for your stay. This is a voluntary program.

If you meet all of the conditions below, you should apply for one of these three cards and for the $600 annual credit:

  1. You have Medicare Part A and/or Part B, and
  2. You don't have outpatient prescription drug benefits from Medicaid, and
  3. Your stay in the nursing home is not being paid by Medicaid, and
  4. You get your drugs through the nursing home pharmacy, not from an outside source such as a community pharmacy or mail order, and
  5. Your monthly income is no more than $1,048 for a single person or no more than $1,406 for a married couple (If you live in Alaska or Hawaii, income limits are different). This means you qualify for a $600 credit in 2004 on your drug discount card to help pay for your prescriptions and another $600 credit in 2005.
    Note: If your state helps pay your Medicare Part A or Part B premiums you may still qualify even if your income is above these amounts.
Note: You can get the $600 credit while Medicare is paying for your nursing home stay. The $600 credit can't be used while Medicare Part A is paying for your stay.

These are the three special Medicare-approved drug discount cards for people with Medicare living in a nursing home who get their drugs through the nursing home's special long term care pharmacy and who want to get the $600 credit if they qualify:

Card Name Sponsor Telephone LTC Card
ACS State Healthcare LLC and the Long-Term Care Pharmacy Alliance 1-866-490-1863
Community Care Rx Computer Sciences Corporation 1-877-646-5307
PBM Plus Senior Care PBM Plus, Inc 1-800-676-8399

To get one of these Medicare-approved drug discount cards:

  • Call the company that is offering the drug discount card through the pharmacy that serves you in the nursing home, and ask for enrollment materials.
  • Fill out the enrollment form for the card and $600 credit.
  • Send the signed enrollment form with this information to the card sponsor.
  • The sponsor will send you a letter letting you know if you are eligible. If you are eligible, you will also get your Medicare-approved drug discount card with that letter.

If you already have a Medicare-approved card, you will be able to switch to one of these special cards. For more information, call 1-800-MEDICARE (1-800-633-4227) or the discount card sponsor. TTY users should call 1-877-486-2048. Your nursing home may provide information or assistance in enrolling.

Produced by the Centers for Medicare & Medicaid Services, June 2004.


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