SEAVIEW - About 60 senior citizens turned out recently to get a road map of sorts to help them through the impenetrable thicket of new prescription discounts.
Tim Smolen, regional manager of the Statewide Health Insurance Benefits Advisors (SHIBA) Help Line conducted a mini-forum at the Peninsula Church Center to help local residents figure out if it makes sense to get the prescription discount cards that became available June 1. Also on hand last week were Doug Scheaffer of Pacific County Senior Information and Assistance and Laurie Green with Olympic Area Agency on Aging.
Smolen started his presentation by saying "This is awfully hard to figure out. I can do this program again if it's needed." He handed out sheets of paper adorned with red, yellow and green stickers, representing a traffic light for those thinking of signing up for any of the prescription programs available.
"Red means 'stop,'" he said. "If you already have Medicaid insurance with coupons or a Medicaid card from the state Department of Social and Health Services or if you have insurance that pays for prescriptions, you won't need the Medicare programs."
Smolen then skipped to the "green light." "That's for 'go,'" he said. "If you can qualify for a free $600 prepaid prescription card, there's no reason not to go ahead and get it."
The card is available to single people who make less than $12,500 per year and to a couple whose income is $16,800 or less. The card works like a gift certificate or phone card, Smolen said, and will be available June 1. The card will expire at the end of December this year and a new one will be required for 2005. Any funds left on the 2004 card will be rolled over to 2005.
The limits are based on gross income. Assets, such as an IRA, aren't counted. In 2006, Smolen said, "everything changes and becomes 10 times more confusing. When I come to explain that one, we'll be here a while."
Moving on to the 'yellow light,' Smolen urged caution. "Go slowly and watch out," he said.
The first and best option is to obtain a card from individual pharmaceutical companies offering drugs for free or at a discount, depending on income. Smolen said people with computers should go to the Olympic Area Agency on Aging Web site at (www.o3a.org) and click on the red "benefits checkup" button. The site contains application forms for prescription information as well as other benefits available to seniors in the area.
Two cards are also worth checking out:
Together Rx Card - A joint effort of seven major pharmaceutical companies that offers savings of 20 to 40 percent on name-brand drugs from Abbott, Astra-Zenica, Aventis, Bristol-Meyers Squibb, Glaxo-Smith-Kline, Johnson and Johnson, and Novartis for individuals with incomes under $28,000 or couples under $38,000. (www.together-rx.com) or 1-800-865-7211.
Glaxo-Smith-Kline Orange Card - 30 to 40 percent discounts for singles whose annual income is under $30,000 or couples under $40,000. No enrollment fee. (http://us.gsk.com/card) or 1-888-672-6436.
Cards issued by Medicare require the applicant to pick one of 40 companies. "You really need a computer to do this," Smolen said. Green or SHIBA volunteers are available to help if no computer is available.
Saying the plan wasn't his idea and that he is only the messenger, Smolen said no matter the choice, the whole prescription plan "is a rigged game. You cannot win. Don't think you are smarter than they are. Don't set yourselves up for heartache and don't worry. Make a decision and make peace with it."
He advised people to go to the Medicare Web site, fill in the blanks that show the list of drug companies and participating pharmacies, "get a card and live happily ever after."
And, just to confuse things further, Smolen warned that the price for any given drug will change from week to week, depending on what the pharmacies pay for them. "It's a moving target," he said. There won't be any information about how much the drug will cost until the pharmacist swipes whatever card an individual chooses. "I realize this is not great news," he said.
Smolen also warned people who try to call the Medicare number "should put the turkey in the oven first. It's very slow."
What happens if a consumer does nothing and doesn't get a prescription card? "Nothing," Smolen said. "You can just go on as you have been and there's less heartache. But 2006 is different. There'll be a lot more at stake if you don't apply on time. Late fees will be charged."
At the end of the meeting Scheaffer reminded people that the Senior I & A office has moved from downtown Ilwaco to 1715A Pacific Highway near Pioneer Road. The phone number is 642-3634 or 1-888-571-6558. Green also may be reached at those numbers.
Other cards offered by pharmaceutical companies are:
Eli Lilly - One month's supply of each prescription for $12, for individuals with incomes below $18,000 or couples under $24,000. (www.lillyanswers.com), 1-877-RX-LILLY.
Novartis Care Card - Offers discounts to individuals with income under $27,000 or couples under $36,000. (www.careplan.novartis.com), 1-866-974-2273.
Pfizer - Offers a 30-day supply of more than 80 Pfizer drugs at $15 each for people whose annual gross income is below $18,000 or $24,000 for a couple. (www.pfizerforliving.com), 1-800-717-6005.
SHIBA has published an eight-page pamphlet that explains options available plus a lot of other information, such as disease-related organizations that offer help with prescriptions. The pamphlets are available at the Senior I&A office.