DE INSURANCE DEPT. - DISCOUNT CARDS
PRESCRIPTION DRUG AND MEDICAL SERVICES DISCOUNT CARDS
Consumers often call the Insurance Department for information on Prescription Drug and Medical Services Discount Cards. These discount card programs are not considered insurance. Although we do not regulate these programs, we have compiled some general information we hope will be useful to you.
There are a large and growing number of private discount card programs that can be used to purchase drugs or medical services such as dental, vision and chiropractic care. These card programs vary significantly in terms of enrollment costs, program features, and prescription drug and medical price discounts.
What is a Prescription Drug Discount Card?
Prescription drug discount cards are also known as consumer cards, point of sale cards, or 100% co-pay cards. They are offered directly to consumers or through employer, association, or other type groups as a way to lower the cost of outpatient prescription drugs, especially for people who do not have prescription drug insurance coverage or who have inadequate coverage.
What is a Medical Services Discount Card?
Medical services discount cards are offered directly to consumers or through employer, association, or other type groups as a way to lower the cost of ancillary health services such as dental, vision, or chiropractic care. These cards are especially attractive for people who do not have insurance coverage for these services or who have inadequate coverage.
Who sponsors Discount Card Programs?
Individuals, groups, organizations or companies may sponsor or market discount card programs. These sponsors might include retail stores, associations, nonprofit organizations, and pharmaceutical manufacturing companies. Sometimes the sponsor is administrator of the program, but more often, the program is actually administered by someone other than the marketing group.
Characteristics of Discount Cards:
7 Are relatively new, all in operation for less than 10 years
7 Are open to all persons, regardless of age or income
7 Are marketed nationwide via direct mail, print and broadcast media, the internet, or through independent agents and brokers
7 Charge an annual enrollment fee
7 Offer discounts at participating network pharmacies including chain and independent retail outlets, and dental, vision, and chiropractic clinics
7 Have mail-order pharmacy service, which generally offers deeper discounts on certain products
7 Do not have formularies, although some might keep a preferred medication list and offer deeper discounts on the drugs used on the list
7 Quote discounts in a variety of ways, making price comparisons difficult
7 Provide some degree of quality assurance and patient safety activities
Enrollment Fees:
An eligible person must sign up to enroll in a discount card program. Some card programs are offered for free while others may require a one-time only fee, a monthly fee, or an annual fee. Fee structures for some programs cover an entire household, while others lower fees for a single individual member. Upon enrolling, the person receives a card that offers discount prices for the outlined services. The range of discounts will vary by card program, and the price resulting from any discount on drugs or medical services may also vary over time due to price fluctuations in the products and services available.
Some Observations:
A single option is unlikely to be optimal for everyone, and the best option for an individual will often change over time as their mix of drugs changes or as discounts from a given option increase or decline.
The only way to determine whether or not a particular card program will give value is to obtain specific price quotes for the drugs or services sought. This may require considerable time and commitment. Comparison-shopping can be tedious and confusing. Typical problems that may be encountered assessing card options may include:
7 Comparing prices is difficult due to lack of a standard method for describing discounts
7 Pricing quotes are limited to a group of available drugs that vary by each card program
7 Frequent price changes
7 No prices available until after enrollment in the card program
7 Availability of mail-order prices only
7 Retail pharmacy discount prices vary from store to store
For individuals with limited or no insurance coverage for drugs and ancillary medical services, some card programs might offer significant savings. Whether the overall savings are greater than could otherwise be obtained, for example, from some chain drugstores, discount department store pharmacies, or mail-order pharmacies for prescription drugs, would need to be researched by the individual.
A Word of Caution:
There are many valuable discount card programs available. In determining whether one is right for you, it is important for you to find out as much as you can about the program. Ask specific questions about pricing, network members, and actual cost to you for the program. Keep the following tips in mind while you do your research:
7 Never sign up for a prescription or medical services discount card without finding out for certain that the pharmacy or health care providers you use accepts it.
7 Do not rely on sales pitches that say a certain rate of pharmacies or health care providers accept the card (for example: over 50 percent of pharmacies accept the card.) These claims may be misleading or simply false.
7 Senior citizens often already receive discounted prices from many pharmacies and other health providers. Check with them first, and never pay large sums in advance for a discount card.
7 If it sounds too good to be true, it probably is.
7 Follow up your inquiries by contacting the appropriate local or state agency for further information or guidance.
7 Check the Internet for additional information by typing in key search words such as discount drug cards or medical discount cards.
Before paying for a discount card, check with consumer affairs or the Attorney Generals office to research any complaints against the company.
