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California's Discount Program

Department of Health Services on Behalf of Medicare Beneficiaries

The Department of Health Services administers the "Prescription Drug Discount Program for Medicare Recipients' under which a pharmacy can charge a Medicare recipient no more than what Medi-Cal would reimburse the pharmacy for the same prescription, plus a 15 cent processing fee. This program, which started on February 1, 2000, is open to any person who is filling a prescription and has a Medicare card. It includes 5000 pharmacies participating in Medi-Cal, plus any other pharmacies that choose to charge a similar price. Virtually every prescription medication is covered. There is no enrollment process for the consumer, and no formulary or prior authorization requirement for any prescription. However, over-the-counter drugs are not covered under this new program.

The price that the Medicare consumer pays for each drug depends on the medication; there is no specific discount from retail prices. In some instances, there will be large savings and in other cases the savings will be small. This program should not affect any prescription coverage a person may already have, although it is intended for those prescriptions whose entire cost is paid by the Medicare recipient. For more information on the program plus the "Medi-Cal price" for the top 200 most requested drugs, click here.




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