CSBG IM No. 83 Partnership Initiative With the Centers for Medicare and Medicaid Services to Help Eligible Low-Income Individuals Reduce Their Prescription Drug Costs
Transmittal No. 83 Date: January 7, 2005
TO: State Community Services Block Grant Program Directors, Community Services Block Grant State Association Directors and Community Services Block Grant Eligible Entities
SUBJECT: Partnership Initiative with the Centers for Medicare and Medicaid Services to Help Eligible Low-Income Individuals Reduce Their Prescription Drug Costs.
The Office of Community Services (OCS) is partnering with the Centers for Medicare and Medicaid Services (CMS) to help ensure that low-income people with Medicare reduce their prescription drug costs by receiving benefits from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which was enacted December 8, 2003.
We want to move quickly to involve more CAAs in providing outreach, education and assistance to as many people with Medicare as possible because the Medicare-Approved Drug Discount Card and Transitional Assistance program will end December 31, 2005 and HHS' new Part D Drug program will begin on January 1, 2006.
During 2005, CAAs can help people with Medicare select a Medicare-Approved Drug Discount Card and apply for a credit of up to $600 toward the cost of their drugs by:
- Obtaining a list of medicines and doses from a person with Medicare;
- Their total monthly income and zip code;
- Calling 1-800- MEDICARE (1-800-633-4227) to receive information about drug card sponsors that offer discounts for the drugs the person with Medicare takes or by going to their website and following the instructions; and
- Enrolling the person with Medicare in a Drug Discount Card program by filling out a short enrollment form (An enrollment fee of up to $30.00 is charged for persons not eligible for the credit).
On a pro-rated basis in 2005, people with Medicare with incomes below 135 percent of the federal poverty level (currently $12,569 for individuals or $16,862 for couples) may be eligible to receive a credit of up to $600 toward the purchase of their drugs. Individuals who receive the credit will pay a coinsurance of 5 or 10 percent for their prescription drugs based on their income. Individuals who are not eligible for the credit will pay the card sponsor's price. It is likely that some CAA staff and volunteers may be eligible for these benefits.
The Centers for Medicare and Medicaid Services (CMS) will provide training, technical assistance, marketing materials, program brochures and applications at no cost to CAAs. Currently, a few Community Action Agencies (CAAs) are receiving funding through a CMS subcontractor and are participating in outreach, education/awareness, and enrollment assistance efforts. We strongly encourage even greater CAA participation on a national level. In addition, it is envisioned that in 2005 CAAs will play an important role in helping to educate low-income Medicare beneficiaries about the new Part D drug benefit coming in 2006.
Toward this end, OCS and CMS invite you to participate on a conference call January 25, at 2:00 p.m. or January 27, at 2:00 p.m. to learn more about this program and how you can help people with Medicare in your community reduce their cost for prescription drugs. To participate on a conference call please dial USA Toll Free 1-877-733-9783, enter the Pass code: 460143 and follow the instructions. You must confirm your intent to participate by sending an e-mail with your name, the name and address of your agency, telephone number and e-mail address to .
Please contact Anita Wright, OCS at 202-690-5660 or Daniel Evans, CMS, at 1-410- 786-3326 if you have any questions.
Clarence H. Carter
Office of Community Services