news release

For Immediate Release

Media Contact: Patty Coyle Locke, 317-488-6249

ADMINASTAR FEDERAL HELPS PROMOTE STATE Rx PLAN

Anthem Subsidiary Distributes Information to Help Seniors with Prescription Costs

Indianapolis, Ind. – May 27, 2003 – AdminaStar Federal (AdminaStar), Indiana’s Medicare contractor for the Centers for Medicare & Medicaid Services (CMS), is partnering with HoosierRx to reach more Hoosiers who may be eligible for the state’s prescription drug program for low-income seniors.

AdminaStar is donating its mailing services in order to distribute 600,000 Hoosier Rx applications to seniors with Medicare. HoosierRx is Indiana’s prescription drug program for low-income seniors. The three-year-old program was developed by Governor Frank O’Bannon and the Indiana General Assembly. This joint mailing program is one of many ways AdminaStar assists organizations that reach out to the senior community.

Michael Dorris, AdminaStar Federal’s Medicare Liaison, created the partnership, which was approved by CMS. “The purpose of reaching out to a program like HoosierRx is to expand partnerships that are directly or indirectly related to Medicare and that help people on Medicare. It also gives AdminaStar a chance to promote a valuable state-wide program.”

A HoosierRx application will be included with seniors’ monthly Medicare Summary Notices. This mail campaign is currently underway and will run through early June. The HoosierRx application will allow eligible seniors who are without prescription drug coverage to apply for prescription drug benefits through the state’s HoosierRx program.

HoosierRx's director, Grace Chandler, stated, "This joint mailing is a way we can inform seniors how they may begin to fill the prescription drug gap in Medicare benefits, until such time as Congress passes a Medicare drug benefit."

HoosierRx allows any eligible senior enrolled to receive a HoosierRx drug card to use at their local pharmacy. With the HoosierRx drug card, eligible seniors will receive 50 percent off of the cost of their medications, up to a yearly benefit cap. To be eligible for the HoosierRx program, a senior must:

be 65 years old or older,
be an Indiana resident (living in the state at least 90 days out of the last 12 months),
not have prescription drug coverage through an insurance plan, Medicaid or Medicaid with a spend-down and,
have a monthly income not exceeding the following amounts:
- $1,011 if single
- $1,364 if married.

The resolution to the Kentucky ambulance claim issues was tackled from several levels. CMS offered advance payments to a selected group of providers who had money tied up in the appeals backlog. This action, combined with enhanced provider education, streamlining claims processing and re-engineering medical review policies, allowed AdminaStar to positively affect the entire claims process. CMS also secured additional funding for AdminaStar to relieve the appeals backlog.

The main part of the strategy was to provide education to all interested groups, including congressional offices, provider groups and professional organizations. They were kept informed about key issues via several sources, including a monthly newsletter, quarterly provider bulletins, and website updates. The most effective exchange of information came through the creation of a dedicated special unit whose goal was to focus strictly on ambulance claims and on issues requiring immediate provider education or process changes.

All seniors who are interested in applying for the HoosierRx drug card will need to complete the short, one-page application included with their Medicare Summary Notice. Once the application is processed, the senior will receive an eligibility letter. If eligible, the senior will receive a HoosierRx drug card and instructions on how to use their card. Once the state finishes paying the 50 percent benefit, seniors can still continue to use their HoosierRx drug card to get a reduced rate on their prescriptions.

Yearly benefits are based upon the senior’s family (themselves, their spouse and any dependent children) monthly income received and prescription drug costs. For example:

If a senior receives a monthly income of $1,011 a month or less for a single person, or $1,364 or less for a married couple, HoosierRx will pay half of their prescription drug costs, up to $500 in a year.
If a senior receives a monthly income of $898 a month or less for a single person, or $1,212 or less for a married couple, HoosierRx will pay half of their prescription drug costs, up to $750 in a year.
If a senior receives a monthly income is $749 a month or less for a single person, or $1,010 or less for a married couple, HoosierRx will pay half of their prescription drug costs, up to $1,000 in a year.

For more information about Indiana’s HoosierRx program, contact HoosierRx toll-free at 1-866-267-4679 or visit the web site.

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