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 H-E-B
Pharmacy
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H-E-B Medicare-Approved Drug Discount Card: Facts for Consumers What does "Medicare-approved" mean for drug discount cards? If a drug discount card is "Medicare-approved" then it has met the Medicare criteria and the plan must follow the rules established by Medicare. These are the only cards that will provide the new discounts allowed by the Medicare law. When will the Medicare-approved drug discount card program begin?
Some consumers are eligible for a $600 credit in 2004 for prescription drug costs. If your income is no more than 135 percent of the poverty line ($12,569 for an individual; $16,862 for a married couple) and you do not have prescription drug coverage from Medicaid, the Department of Defense's TRICARE program, the Federal Employee Health Benefits Program or group insurance coverage—you may be eligible for a $600 credit in 2004 and another $600 credit in 2005 to be used toward your prescription drugs. Plans will ask you about your income on their enrollment form to help them decide if you can get this credit. 2004 Department of Health and Human Services Federal Poverty Guidelines:
Do I get the $600 low-income credit if I sign up in 2005? If you sign up for a discount card program in 2004 and qualify for this assistance, you can get the entire $600 benefit for 2004 and another $600 in 2005. If you sign up for a discount card in 2005, you may not get the entire $600, depending on which month you sign up. Even with this $600, you will have to pay a 5 percent co-pay on each prescription to your pharmacist if your income is below 100 percent of the Federal Poverty Level and a 10 percent co-pay on each prescription if your income is below 135 percent of the Federal Poverty Level. Will I lose the $600 low-income credit if I don't use all of it in 2004? Any of the $600 low-income credit that you do not use in 2004 will be saved in your account so that you can use it in 2005, as long as you stay enrolled. How do I sign up for a Medicare-approved drug discount card? On May 3, 2004, H-E-B will have a card that will offer a great value for our customers. Be sure to check out our card before you sign up for another one. Medicare-approved plans will send you information on how to sign up for approved card plans. How will I know which card to choose? This can be a difficult decision. Talk to your H-E-B pharmacist. He or she will be able to help you choose a plan based on the medication you take and the discounts available; the enrollment fee; and the pharmacy you would like to use. Make sure to bring your pharmacist a list of all the medications that you take. You can also go to the Medicare Web site at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Para una copia en español, llame gratis al 1-800-MEDICARE (1-800-633-4227). Los usuarios de TTY deben llamar al 1-877-486-2048. H-E-B will be able to tell you how much you will pay with their card and the savings associated with the card. How many Medicare-approved cards can I have? You may only have one Medicare-approved card. Can I still use my other discount drug cards even if they are not Medicare-approved? Yes. You may choose one Medicare-approved card but you can keep your other discount drug cards even if they are not Medicare-approved. You will be able to use both Medicare-approved and unapproved cards. Some cards may give you a better price than others. You should compare what you would pay for your prescriptions with each of your cards to make sure you are making the best choice. Only the Medicare-approved cards give consumers with low-income access to the $600 credit. Will H-E-B take Medicare-approved cards? H-E-B will take most Medicare-approved discount drug cards. However, if you shop at H-E-B you should seriously consider the advantages of the H-E-B Discount Card. Can I switch Medicare-approved discount drug card plans? If you enroll in a discount card program in 2004, you may change cards between November 15 and December 31, 2004, for the 2005 coverage period. There is a dis-enrollment process. How much will I have to pay to get a card? Good news! The H-E-B Medicare-approved discount drug card has no enrollment fee. Each Medicare-approved drug discount card plan may charge an annual fee to get their card, but they cannot charge more than $30 a year. How much will the Medicare-approved discount drug cards save me? Medicare believes you will save 10 to 20 percent on your total drug costs, with most cards. H-E-B's discount drug card will offer up to 30 percent or more savings on brand-name and generic cards. Be sure to talk to H-E-B about their savings before you select a card. How can I find out how much I'll spend on a drug? Medicare will have pricing information on its Medicare Web site (www.medicare.gov)(link to http://www.medicare.gov) that will allow you to compare the various Medicare-approved discount card programs. The prices displayed will be the highest a plan can charge for a drug in your area. H-E-B will also publish a list of pricing for the H-E-B card, beginning May 3. Just see your pharmacist for more details on the H-E-B card. What if I am in a Medicare managed care plan? If you are in a Medicare managed care plan (Medicare Part C or Medicare "Choice") your plan might decide to provide you with a drug discount card. If your Medicare managed care plan has a drug discount card, they might automatically enroll you into its program. They must tell you if they are going to enroll you in their program before it happens. Even if your Medicare managed care plan has a drug discount card program, you do not have to enroll in it. But if you choose not to enroll in your Medicare managed care program's drug discount card program, you cannot enroll in any other Medicare-approved drug discount card program. If your Medicare managed care plan does not offer a drug discount card, you can choose any Medicare-approved drug discount card offered in your area. Can I enroll in a Medicare-approved card if I am receiving benefits from a State pharmacy assistance program? Yes, as long as it is not Medicaid. You do not qualify if you are on Texas Medicaid. Can I keep my Medigap drug benefit policy and get a Medicare-approved discount card? Yes. You can get a Medicare-approved drug discount card even if you have a Medigap policy. The discount card and your Medigap policy will work together. Answers compiled from American Pharmacists Association's 2004 Medicare-Approved Prescription Drug Discount Card Issue Brief and the Medicare Reform web site's Frequently Asked Questions section at www.medicare.gov. For a general overview about the card, read about the Medicare-Approved Drug Discount Card. |
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