For members insured under Medicare and a supplement plan through our state and local government insurance programs, it would be a waste to pay up to $30 for one of these cards, which at best provide only a meager savings for struggling seniors without prescription drug insurance.

For example, without a discount card, the average cost of a 30-day supply of Lipitor 10mg, a common cholesterol prescription, is $80. With a discount card the average cost is $70, a savings of only 14%.

The same prescription for a state retiree holding an Express Scripts card, the most common prescription drug provider for state and local government retirees, would cost $20. By ordering a 90-day supply through the Express Scripts mail order plan, the cost would be only $40. Members holding similar prescription drug cards, as provided by their local government insurance plan, have co-payments that vary.

"We've been emphatic that our members don't need the Medicare prescription drug program and, therefore, shouldn't join it," stresses Insurance Coordinator Cheryl Stillman. "When I see what those signing up for a discount card must do, it only reaffirms our earlier advice and gives me reason to be relieved that we don't have to get one.

"After reviewing Medicare's publications on the discount program, I expect that many senior citizens have been frustrated and overwhelmed by the process. Just look at Medicare's official booklet on choosing a discount card, which is 36 pages long and even includes a glossary to help explain technical terms used in it."

Created as a temporary program, primarily for those who had no drug coverage until the drug benefit plan (the new Part D of Medicare) takes effect on January 1, 2006, Medicare's drug discount card has two components. First, a Medicare recipient, who buys a card from among those approved by the feds and available in their area, will receive discounts on their prescriptions - the amount of the discount varying from one card to the next.

Second, low-income Medicare recipients ($12,569 for a single person and $16,662 for a couple) will also receive a $600 credit in 2004 and again in 2005 toward their drug purchases, in addition to a free discount card. They use the credit by making a co-payment on each of their drug purchases, equal to 5% or 10% of the prescription price, until their co-payments total $600, at which point the credit is exhausted for that calendar year (either 2004 or 2005).

According to Stillman, "Confusion reigned from the moment that the cards became available in May, since Medicare approved dozens of different sponsors with their own discount card. Consequently, one faced the difficult task of comparing the sponsors in their area, in order to determine the best deal."

Critics of the program complain that even if one completed the selection process and paid for the discount card that best suited their needs, there is no guarantee their decision will hold up. That's because an individual, once they decide on a card, can't switch it for one year, but the sponsor of their card can change the drugs that they discount, as often as every 7 days, and the price of the drugs.

State retiree Christopher Pauli of Brookline says the prescription drug law that Congress passed should be called the "Pharmaceutical Welfare Relief Act." Pauli, a former DET employee, feels that "seniors are being deceived if they think the discount cards involve largess on the part of the government."

"Despite increased co-payments, I think that most members agree that their prescription drug coverage, whether as a Medicare or non-Medicare participant, far exceeds anything offered by discount cards," states Association President Ralph White. "It remains to be seen where Congress is going with the new program. As it now stands, it is of little substance, except perhaps for poverty level seniors."

Editor's Note: Express Scripts prices vary, depending on the contract of the insurer. For example, City of Fall River retirees are also insured by Express Scripts. These members pay $10 for a 30-day supply of Lipitor, and pay the same price ($10) for a 90-day mail order supply of Lipitor. In fairness, it should be pointed out that Fall River retirees' insurance premiums are about 43% higher than the state's.

In Woburn, another Express Scripts community, retirees pay $20 for a 30-day supply of Lipitor, and the same ($20) for a 90-day mail order supply. But again, Woburn's premiums average 50% higher than the state's.