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States Try to Help Low-Income Seniors With Drug Costs

  • August 6th, 2002

With Congress unable to decide on a prescription drug benefit for Medicare recipients, more and more states are taking matters into their own hands to at least give low-income Medicare beneficiaries some relief from high cost of drugs.

Most recently, Maryland and South Carolina have received permission from the federal government to allow low-income Medicare beneficiaries to purchase their prescriptions through the Medicaid program.

In Maryland, Medicare beneficiaries with annual incomes up to 175 percent of the federal poverty level, or $15,505 for an individual, will pay 65 percent of the prescription's cost. Those with annual incomes at or below 116 percent of the federal poverty level, or $10,278 for an individual, will pay only a $5 copayment per prescription. State officials estimate that this will extend coverage to 90,000 low-income seniors.

South Carolina's program will allow the state to extend prescription drug coverage to seniors with annual incomes up to 200 percent of the federal poverty level, or $17,720 for an individual. The program provides inexpensive prescriptions after seniors pay a $500 annual deductible.

The federal government already has approved similar programs in Michigan, Wisconsin and Vermont. The programs are authorized under a federal initiative announced in January called Pharmacy Plus, under which states can apply to the federal government for waivers to extend Medicaid coverage for prescription drugs to Medicare beneficiaries with annual incomes up to 200 percent of the federal poverty level.

Supreme Court to Hear Maine Case

Meanwhile, the U.S. Supreme Court has agreed to hear a challenge to Maine's proposal to allow the state to serve as a pharmacy benefit manager and obtain reduced drug prices for the 325,000 state residents who lack prescription coverage. Under the program, the state would negotiate with drug makers for discounts similar to those given to the Medicaid program. The program was enacted by the state legislature in 2000 (see ElderLawAnswers news article), but has been delayed by a pharmaceutical industry legal challenge.

Click here to search for and retrieve a July 31, 2002, Baltimore Sun article about Maryland's program, "Medicaid coverage expanded in state."

Click here for a Myrtle Beach Sun News article on South Carolina's program.

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Ron M. Landsman, P.A.
Rockville, MD

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Fairfax, VA

Last Modified: 08/06/2002

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