Despite significant PR expenditures, we're not off to a good start with the Medicare drug discount card program. Sign-ups begin Monday May 3, just a few days away and discounts begin June 1.
But indications are that even the professionals who will be helping the public deal with the program are confused. If so, how is the public going to deal with this? CMS has FAQs on its website. It's a great thing to do, but isn't it reminiscent of what software companies do when their program interfaces are confusing? In both cases, the user will get blamed but really it's all in the design.
There are no indications yet regarding whether or how New York might tie-in its own pharmaceutical assistance program, EPIC. New York might save some money by auto-enrolling EPIC beneficiaries in a Medicare program (by having the Medicare discount kick in first), but advocates don't want those using EPIC to also need to carry a second card. It's more confusion and would lose the benefit of catching some potential drug interactions. We're cutting it a bit close here ...
The discount card programs will be allowed to revise the list of prescription drug prices each week, but generally Medicare beneficiaries can switch cards only during an open-enrollment period at the end of the year. What a set-up for a bait and switch.
Then of course, there are questions about just how much the program will save beneficiaries. CMS itself estimates savings between "10-25% on many drugs." Check also here and here. Some folks have suggested that since the discounts are off of "average wholesale price," (AWP) the average discounts will amount to nil. There are also questions about how many will participate.
Medicare members who decide to join the program can choose only one card, which can carry a maximum annual fee of $30. Card holders may qualify for a $600 subsidy toward the cost of their drugs if their annual incomes are below $12,569 for individuals or $16,862 for couples.
No doubt Congress wanted something in place before the election and that's why they went with this "relatively" simple initiative, saving the more complex and controversial pharmaceutical program for later. They may rue the day.