Prescription Drug Costs for Seniors Enrolled in Medi-Cal Likely To Increase Under Medicare Law
About 937,000 California seniors and people with disabilities currently enrolled in Medi-Cal likely will face increased prescription drug costs and more limited coverage when they are transferred to Medicare for prescription drug coverage in 2006, the Sacramento Bee reports. Currently, Medi-Cal beneficiaries make a $1 copayment for drugs, and most often, the fee is waived because pharmacists legally cannot withhold prescriptions for lack of payment. Under the new Medicare law, beneficiaries will be required to pay $1 or $2 for generic medications and $3 or $5 for brand-name prescriptions, depending on their incomes. According to Stephen Deering, deputy regional administrator for CMS in San Francisco, pharmacists might still choose to waive copays under the Medicare law. In addition, under the law, Medicare is expected to provide coverage for two medicines in each drug category, compared with Medi-Cal, which covers all FDA-approved drugs. Medi-Cal also pays for weight-loss drugs and over-the-counter medications, which the Medicare benefit will not cover. State officials could opt to maintain drug benefits at their current level by supplementing the Medicare benefits, but "that may be unlikely given the state's dire budget shortfall," according to the Bee (Weaver Teichert, Sacramento Bee, 3/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.