MADISON, WI (WSAU-PR) - Wisconsin received formal approval from the Centers for Medicare and Medicaid Services (CMS) for renewal of the SeniorCare Waiver until 2015. SeniorCare, Wisconsin’s prescription drug program launched in 2002, provides affordable, comprehensive prescription drug coverage to thousands of Wisconsin seniors.
Governor Scott Walker says, “I am pleased to announce SeniorCare’s renewal to Wisconsin’s parents, grandparents, friends, and neighbors, who depend on it, It’s important for Wisconsin’s seniors to be able to get the prescription drugs they need at an affordable price.”
In addition, SeniorCare now includes Medication Therapy Management (MTM). This is a new covered service for SeniorCare members. Medication therapy management creates a partnership between pharmacist, patient, and physician to better coordinate the delivery of medications.
SeniorCare continues to be a popular and successful program, with a simple enrollment process, a $30 annual enrollment fee, income-based deductibles, and co-payments of $5 for generic drugs or $15 for brand drugs. Since its inception, more than 152,000 Wisconsin seniors have purchased prescription drugs through SeniorCare.
SeniorCare prescription drug assistance program is available to all seniors 65 years of age or older with an income at or below $22,340 per year for an individual or $30,260 for a married couple. About 75 percent of Wisconsin seniors enrolled in SeniorCare are women.
Although the majority of SeniorCare members have been enrolled for two years or less, 11 percent are charter members and have been enrolled since the start of the program 10 years ago.
Out of pocket costs for SeniorCare members decreased due to a combination of factors:increased use of generic drugs, increased rebates from drug companies, and changes in reimbursement to pharmacists.
Many seniors are enrolled in both SeniorCare and a Medicare Part D drug plan or private insurance. Almost 40 percent of those enrolled in SeniorCare have some other type of prescription drug coverage as well, and SeniorCare coordinates benefits with these programs.
For most Wisconsin seniors, SeniorCare provides a better value than Medicare Part D. However, Part D is better for the lowest income members who qualify for federal subsidies and for members with high drug costs.
According to the Governor's office, the state Fiscal Year 2011 costs of SeniorCare were $108.9 million, divided among rebates from drug manufacturers (40%), the federal government (21%), members (19%), state funds (13.6%), and other insurance (6.7%).
The SeniorCare waiver is estimated to lower total net Medicaid spending by $146 million in 2011, of which $53 million will be state savings.
For more information about SeniorCare, call the SeniorCare hotline at (800) 657-2038 or go to dhs.wisconsin.gov/seniorcare.