Millions to get Medicare drug card for immediate use

Washington -- Federal officials are automatically signing up nearly 2 million low-income beneficiaries in the Medicare prescription drug discount program in a move to jump-start enrollment.

The effort specifically targets people who receive help from Medicaid to pay their Medicare premiums. Roughly 1.8 million beneficiaries will receive one of 19 randomly assigned drug cards in the mail this month for immediate use at pharmacies.

The recipients, who also are set to receive a $600 federal credit on the cards in 2004, are required to make a single phone call confirming their eligibility to the Centers for Medicare & Medicaid Services before the subsidy is activated.

CMS launched the discount card program in June with the hope of enrolling nearly 5 million of the roughly 7 million low-income seniors eligible both for this year's subsidy and another $600 in 2005. With a little more than a year to go in the program, the agency has signed up just more than 1 million out of this group.

Critics of the drug card initiative contend that the enrollment system is arduous and confusing to many seniors, leading to a lackluster debut. Medicare officials counter that the effort's opponents are interfering with education and outreach by scaring beneficiaries away from the cards.

Time is the main factor prompting the latest CMS move. Eligible beneficiaries who enroll by the end of December will be able to carry over this year's subsidy into 2005, but those who do not will lose out on the money.

The American Medical Association welcomed the automatic enrollment announcement and urged all low-income seniors to take advantage of the available funding regardless of whether they are included in the mass mailing.

"Besides making sure that low-income Medicare beneficiaries get the $1,200 in prescription drug credits for which they are eligible in 2004 and 2005, this mailing is an important first step toward getting seniors signed up for the more extensive drug coverage program that begins in 2006," said AMA President John C. Nelson, MD, MPH.

Automatic enrollment is not a new element of the drug card initiative.

Beneficiaries participating in Medicare Advantage, as Medicare managed care is now known, and state pharmacy assistance programs were signed up by their plan sponsors. These people account for the bulk of the more than 4.4 million beneficiaries currently using the cards to get discounts on medicines.

Congressional Democrats had been calling on CMS to institute automatic enrollment for low-income Medicare beneficiaries receiving Medicaid help since before the launch of the initiative. CMS Administrator Mark McClellan, MD, PhD, explained that the delay in accomplishing the goal was due to myriad legal and technical issues.

The CMS chief suggested that such barriers could prevent the agency from expanding the auto-enroll list anytime soon. He noted that contact and eligibility information for low-income seniors who are not in special Medicare programs is often difficult to obtain. "Part of the problem is identifying who they are," Dr. McClellan explained.

The Access to Benefits Coalition, a patient advocacy group that includes the AMA, recently launched a new online tool designed to inform low-income Medicare beneficiaries of their support options. The coalition wants to help enroll nearly 1 million more seniors than CMS hopes to reach.