So far only 4,000 of 50,000 slots have been filled in new demonstration prescription drug assistance program

Sep 18 2004

The Chairman of the U.S. Senate Special Committee on Aging is encouraging those on Medicare who have cancer and other serious diseases to consider signing up for a new demonstration prescription drug assistance program.

Under the effort, Medicare will pay for certain drugs and biologicals (vaccines, hormones, antibodies, and blood products) which can be taken at home. The coverage pays for up to 90 percent on the cost of oral and self-injectable drugs.

"If you have a serious illness and are paying for expensive miracle drugs, especially if you are on a limited budget, I strongly encourage you to enroll," said Sen. Larry Craig (R-Idaho), chairman of the Senate Aging Committee. "If you apply now, there is a good chance that you could be approved."

The demonstration program was made possible when Congress passed the historic changes to Medicare last year. Enrollment was set at 50,000 people – but so far only 4,000 have signed up. If Medicare receives more applications for the demonstration than can be enrolled, participants will be chosen by random selection.

"I think there is probably a lack of knowledge about this demonstration program just as there is with the temporary drug discount cards now in place," Sen. Craig said. So far nearly 4.5 million seniors are now enrolled in the new, temporary, Medicare approved drug discount cards which are saving seniors nearly 20 percent off the retail price of drugs. Both the current Medicare approved drug discount cards and the demonstration program for major illnesses will be replaced when the full Medicare drug benefit starts in 2006.

Under the demonstration program, Medicare beneficiaries with cancer, multiple sclerosis, rheumatoid arthritis, and other serious diseases who applied by August 16 of this year began receiving benefits on September 1. The next enrollment period ends September 30 – those who apply by then and are enrolled will begin receiving benefits by October 18.

Also, just like the Medicare drug benefit, the demonstration program benefit allows beneficiaries with monthly incomes below $1,047 a month for an individual or $1,405 a month for a couple to reduce their costs for the drugs included in the demonstration to $5 per prescription or less. Beneficiaries with incomes below 15 percent of the federal poverty level and limited assets also qualify for additional assistance.

A complete list of covered drugs, and other information can be downloaded from the CMS Web site. Customer service representatives are available at 1-866-563-5386 to answer questions and help seniors obtain and complete the application.