| FOR IMMEDIATE RELEASE Tuesday, July 30, 2002 |
Contact: | CMS Public Affairs (202) 690-6145 |
"This creative program from Maryland helps those low-income seniors who are most in need of prescription drug coverage," Secretary Thompson said. "We will continue to support state efforts to expand drug coverage to seniors under this program even as we work to establish a drug benefit available to all Medicare beneficiaries."
Maryland is among the first states to receive federal funding to extend Medicaid prescription drug coverage to seniors using the principles of the new Pharmacy Plus initiative. HHS today also announced the approval of a similar program in South Carolina and previously approved similar programs in Illinois and Wisconsin.
Maryland's program targets seniors in two income groups -- those at or below 116 percent of the federal poverty level (FPL) in Group I and those whose incomes are at or below 175 percent of FPL in Group II. The FPL for 2002 is $8,860 for an individual.
Participants would not otherwise be eligible for Medicaid and will receive only the drug benefit. Individuals in Group I (about 46,000 expected) are generally currently enrolled in a program run by the state. This includes non-elderly who are not disabled but may have a chronic illness such as diabetes or high blood pressure. All qualified Medicare beneficiaries (a program for very low-income Medicare enrollees) will also be eligible to enroll in Group I. Group I participants will receive a limited pharmacy benefit and related supplies. Under this amendment to the state's current 1115 waiver, both groups will receive all Medicaid drugs. Group I will have a $5 copay for their prescriptions.
Individuals in Group II (about 44,000 expected) have slightly higher incomes and will receive Medicaid drugs at a 65 percent co-insurance. There will be no limitations on the number of refills for either group.
Since President Bush and Secretary Thompson announced the Pharmacy Plus initiative in January, many states are considering this type of Medicaid expansion to provide relief to low-income seniors in the face of increasing prescription drug costs.
Today's approvals come on the 37th anniversary of the day President Johnson signed the legislation that created the Medicare program to ensure seniors had adequate health coverage. By law, the Medicare program, which provides health coverage to about 40 million seniors and disabled Americans around the country, does not cover most prescription drugs.
Maryland's program and the Pharmacy Plus initiative are authorized through an expansion of Medicaid, a state and federal partnership that provides health benefits, including prescription drugs, to more than 40 million low-income Americans.
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