March 30, 2006

Q: I'm on Medicare and get my four medications free from a pharmaceutical company assistance program. I am afraid that I won’t be able to afford my medicines if I have to give up this program and sign up for a Medicare drug plan. Can’t I just stick with what I have? --Richard

Dear Richard:

There have been many news stories about seniors who are worried about losing the help they get from programs sponsored by pharmaceutical companies. The concern arises because Medicare does not allow drug company programs to coordinate directly with the private Medicare drug plans. This means if someone signs up for a Medicare drug plan, they may no longer be able to get free or low-cost medications from one of these programs.   

For seniors who have been helped by one or more of these assistance programs, this can create quite a dilemma. On one hand, it might be tempting to stick with the programs to get help with relatively high-cost medications, particularly given uncertainties about the new Medicare drug plans. On the other hand, it is not clear if the pharmaceutical assistance programs will be available to seniors in the future. Even if they continue, seniors could face a late enrollment penalty if they fail to sign up for a Medicare drug plan when they are first eligible.

One option, at least in the short term, would be to continue to take advantage of these programs. But during this period, it would be a good idea to do some research so you are ready to sign up for a Medicare drug plan by May 15. 

In addition, if your income is below about $20,000 and you have resources below $11,500, you may qualify for the extra help in paying for prescriptions through the Medicare drug benefit. The extra help eliminates or significantly reduces the premium and deductible you would otherwise be required to pay and lowers your copayments to no more than $5 per prescription.

This column was prepared by the Kaiser Family Foundation, an independent, non-profit private foundation based in Menlo Park, Calif., that is not affiliated with the Kaiser Permanente health plan. Do you have questions about the new Medicare drug benefit? Send your questions to Medicare Q and A. The Kaiser Family Foundation. 1330 G St., NW. Washington, DC  20005 or MedicareQ@kff.org. 

(c) 2006, Knight Ridder/Tribune News Service.

Distributed by Knight Ridder/Tribune Information Services.