Long Term Care Cards: Pharmacy Benefits
CMS Approval Date: mm/yyyy Date of last update: 08/2004
Information may not be current
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FACTS ABOUT THE LTC CARD
What is the LTC Card?
The LTC Card is a new Medicare-approved program that provides low-income Medicare beneficiaries who live in nursing facilities with access to a $600 government credit to help pay for their prescription medicines. The LTC Card will operate until the full Medicare prescription drug benefit takes effect in 2006.
The LTC Card is offered by the Long Term Care Pharmacy Alliance in conjunction with ACS State Healthcare, LLC. The LTCPA has extensive experience in serving the special needs of nursing facility residents.
Why is the LTC Card being offered?
Programs like the LTC Card are becoming available under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This law created an important new benefit called "temporary (transitional) assistance" for low-income nursing facility residents: starting on May 3, those who qualify for Medicare and have an annual income of less than 135 percent of the federal poverty level can enroll in a temporary assistance program, which will provide a credit of up to $600 per year toward the cost of medications until the new prescription drug benefit begins in 2006. The LTC Card is approved by Medicare, but it is separate from the Medicare program.
How will the LTC Card benefit pharmacy practices?
The benefits provided by the LTC Card will attract more people to the quality care that pharmacy practices already provide to millions of residents. Long-term care pharmacy practices provide valuable services that help long-term care residents manage the many medications they take each day, and these pharmacists are key in providing the around-the-clock attention needed to ensure residents' safety and compliance. The LTCPA recognizes that long-term care pharmacists experience high costs to deliver these services to nursing facility residents. As a result, the LTC Card incorporates provider agreements that help meet the financial needs of the long-term care pharmacy community - and preserve the value of the services provided by the long-term care pharmacy.
How will the LTC Card meet the needs of the residents served by nursing facility pharmacies?
The LTC Card is offered by the LTCPA, whose members provide special care through highly trained and qualified long-term care pharmacists with particular expertise in managing the many complex medications prescribed to nursing facility residents. A specially trained pharmacist's experience can help a nursing facility monitor the safety of its residents, who often take as many as eight different medications a day.
Are there any special services associated with the LTC Card?
As you know, LTCPA-affiliated pharmacists provide a host of specialized services for nursing facilities and their residents, and the LTC Card will include these services. As a standard practice, these specialized services include implementation of drug regimen reviews (to analyze the medications a resident is taking) at least once every 30 days, and often more frequently. Based on these reviews, LTCPA pharmacists then make professional recommendations about the specific medications a resident is taking, helping nursing facilities identify the need to:
- Change the dosage of a drug or its dosage form
- Discontinue a drug if there is no demonstrated medical need
- Substitute a different drug for one currently being prescribed
- Add a new drug to better control a medication
Will long-term care pharmacies across the country be able to enroll residents in the LTC Card?
Yes, the LTC Card will be widely available. The LTCPA's member companies (Kindred Pharmacy Services, Omnicare, NeighborCare and PharMerica) serve three out of every five nursing facility residents in the nation, and the LTCPA maintains a network of nearly 500 pharmacies associated with nursing facilities across the country.
How can pharmacists help nursing facilities determine if their residents are eligible for the LTC Card?
To determine a resident's eligibility, the enrollee, or her representative must simply confirm that she is a Medicare beneficiary and his or her annual income is no more than $12,569 if single or no more than $16,862 if married. It also is important to know that nursing facility residents can be enrolled in only one Medicare-approved temporary assistance card at a time.
How long does it take to enroll residents in the LTC Card?
The enrollment process for the LTC Card is easy and should not take long. Long-term care pharmacies simply need to submit completed and signed enrollment forms to the LTC Card by fax or postal mail. (Faxes can be sent toll-free to 866-213-6066; mail can be sent to LTC Card, C/O LTCPA LTC Card, PO Box 502368 , Atlanta , GA 31150 .)
Where can I get enrollment information for the long-term care residents I serve?
Once outreach materials are approved by the Centers for Medicare and Medicaid Services,
LTC Card enrollment and informational materials will be available through a variety of
" Through all LTCPA member companies
" Through the LTCPA Web site at ltcpa.org\ltccard