Confusing new drug plan lowers costs, if you search

Paul Thissen

The options can be dizzying.

Seniors face a multitude of state and federal prescription-buying choices, now that they can apply for federal drug savings cards — an option that became available last week.

The federal plan, created under a Medicare bill passed in December, allows seniors to choose from dozens of privately-operated prescription drug cards. Paying an annual fee of about $30 allows seniors to fill their prescriptions at some approved pharmacies and mail-order firms.

But the choice of a prescription plan is not as simple as paying a one-time fee and watching the savings accrue.

Different Medicare cards offer varying drug prices and options for pharmacy locations. The catch? Seniors must choose between using the federal or state prescription program; they cannot have both.

Illinois seniors should stick to a similar state plan, the Illinois Rx Buying Club, said Nancy Flowers, Evanston’s long-term care ombudsman.

“In some states, the feeling is, this is better than nothing,” Flowers said.

In theory, seniors can choose the plan that will save them the most. Unfortunately, gathering unbiased information about the different plans is difficult. Local pharmacies often push a single plan, giving out advertising booklets and applications without providing any information about the other choices that are available.

The federal government provides comparative information about the new Medicare cards online or over the phone, but both systems are slow and confusing.

Besides the difficulty many seniors have with using the Internet, calling the Medicare numbers provided online will get you a machine, not a human.

“It’s very confusing,” Flowers said.

Price information for the Illinois plan is even more difficult to locate. The state only puts a few sample drug prices online; everything else must be found at individual pharmacies. Pharmacies often only will give out pricing information in person, not over the phone.

“It will be much more difficult for (seniors) to make decisions based on quality,” Kellogg School of Management Prof. Leemore Dafny said. “They’re much more likely to (choose) based on advertising.”

Even careful research does not provide a clear choice for the best prescription plan. The cheapest Medicare plan and the Illinois plan have almost exactly the same prices for a selection of Alzheimer’s drugs. The only Medicare plan advertised by Osco Drug, 1630 Sherman Ave., is more expensive than either the Illinois prescription plan or the cheapest Medicare discount card.

However, U.S. Rep. Jan Schakowsky, D-Evanston, also told seniors to stick with the Illinois plan. Schakowksy voted against the Medicare bill, which primarily was supported by Republicans.

“Those of us from Illinois do much better with the Illinois’ buyers club card,” she said at Friday’s Aging Well conference in Evanston.

Further complicating decisions, state and federal governments have different standards for providing additional low-income benefits. Illinois benefits apply to any single senior earning less than $18,620, while the federal plan applies only to those earning less than $12,569 per year.

Seniors do not have to figure out what Illinois plan fits them best, however; filling out one application automatically enrolls them in whatever state program provides the most benefits. Under each system, qualifying seniors pay only a small fraction of the drug costs.

But Dafny said the competition provided by the new Medicare bill is a good thing. More options for prescription-drug plans will lower prices for everyone, she said.

“I think it’s likely to yield better plans on the whole,” she said. “I don’t think restricting competition is likely to give seniors a better deal.”