IN ADVANCE OF MEDICARE REFORM:|
The Act follows a previous unsuccessful program initiated last year by the state, which included monthly $40 premiums and limited eligibility to just 17 rural Maryland counties. The premiums made the plan unaffordable for many. Only about 1,000 seniors signed up.
With the new Drug Relief Act, premiums have been brought down to a much more affordable $10 per month. In addition to this premium, prescription copayments are priced at $10 for generic drugs, $20 for preferred drugs with brand names, and $35 for non-preferred drugs with brand names. The no-deductible policy replaces a $50 monthly deductible. The plan provides for a maximum of $1,000 relief per person, per year.
In order to qualify for the programs coverage, candidates must be age 65 or over or be disabled. Applicants must be eligible for Medicare and have a yearly income of $25,770 per person or $34,830 per couple. Total household income cannot exceed 300% of the federal poverty line.
The program will be funded through hospital discounts which the state provides for the CareFirst, MAMSI, and Aetna insurance companies. These discounts are included in a program knows as SAAC, the Substantial, Available, and Affordable Coverage Program. The insurance companies are legally obligated to contribute the value of the states discounts to the new prescription drug program—an estimated $22 million
CareFirst, the states largest non-profit health insurer (though the company is now considering going for profit), has signed a two-year contract with the state to administer the program.
Throughout the U.S., one-third of the population under Medicare lacks prescription drug coverage. In Maryland alone, almost 200,000 people lack adequate prescription drug coverage. The new program will cover only 30,000 of those 200,000. Though many will still be without coverage, This is a great improvement, says Delegate Peter A. Hammen of the 46th District. The number of people who do not benefit from the program, he said, will increase demand for coverage and put greater pressure on Congress if it doesnt act soon. He called the new state program a Band-Aid, meant to be in effect only until an adequate prescription plan has been issued by the federal government under the Medicare program.
Enrollment in the new state program is on a first-come, first-serve basis.
Call CareFirst for applications at 1-800-972-4612.
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This story was published on June 27, 2001.