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New York Prescription Saver

Frequently Asked Questions for Applicants and Members
(Effective May 29, 2009)

Section 1: How Does the New York Prescription Saver Work?
What is the New York Prescription Saver card?

The New York Prescription Saver is a pharmacy discount card sponsored by New York State. This program offers discounts on prescription drugs to New York residents who have limited incomes, and are either 50 to 64 years of age or have been determined by the Social Security Administration to have a disability. The card is free and can provide savings on your prescription medications right at the counter.

Is this run by a business?

No. The New York Prescription Saver card is sponsored and operated by the State of New York. Savings are provided to you through the generous cooperation and support of your local pharmacies, and some pharmaceutical manufacturers.

How much can I expect to save with the New York Prescription Saver card?

Savings will vary depending on the quantity, type and brand of the drug purchased. In general, you can expect savings of up to 60% off the retail price of generics, and up to 30% off the retail price of brand name drugs. All drugs receive a discount from the pharmacy, and many drugs receive an additional discount from the manufacturer which further reduces the price.

Is there a discount on every drug?

The New York Prescription Saver card offers discounts on nearly all brand and generic prescription drugs. There are very few drugs that are not included in the program. These exceptions include Drug Efficacy Study Implementaion (DESI) drugs and medications used for the treatment of erectile dysfunction.

Are specialized and expensive drugs included?

Yes. Many medications that are used to treat chronic diseases are covered, even those that are very expensive. However, drugs that have to be injected by your physician, like some chemotherapy drugs, are not included. Only prescription drugs that are dispensed at a participating pharmacy are included. Check with your pharmacist for more details.

Are there discounts on diabetic supplies?

Yes. The New York Prescription Saver card provides discounts on some diabetic supplies such as insulin, insulin syringes and insulin needles; if accompanied by a prescription from your doctor. Test strips and glucose monitors are not covered.

Section 2: How to Apply for the New York Prescription Saver Card
Who can join?

You may qualify if you are 50 to 64 years of age or have been determined disabled by the Social Security Administration (SSA) and your annual household income is no more than $35,000 if single or $50,000 joint income if married. You must also be a resident of New York State and not receiving Medicaid.

What does it mean to be "determined disabled by the Social Security Administration?"

SSA has a detailed process for reviewing medical and work information about an applicant and making a determination regarding whether the individual meets the specific rules about disability that are established in law. Individuals who have been determined "disabled" by the SSA, and are eligible for Social Security Disability Insurance (SSDI), Disabled Widow's or Widower's Benefits, Disabled Adult Child Benefits, or are determined disabled by the SSA based on visual impairment are all eligible for the discount card.

How do I apply?

You can apply for the New York Prescription Saver card online, by mail or by telephone. Online applicants will need to affirm that the information provided on the online application is true, complete, and accurate. To apply by mail, an application form and brochure is available for print on the web site. Or, you can call 1-800-788-6917 to apply by phone or request an application brochure. If you are approved, a New York Prescription Saver card will be mailed to you usually within two weeks of receipt of the application. As soon as you get the new card, you can begin saving at participating pharmacies.

Can I enroll while waiting for SSA to determine my eligibility for SSDI?

No. You must have already been determined to have a disability by the SSA and otherwise eligible in order to enroll in the New York Prescription Saver card. However, if you are 50 to 64 year of age and meet the income requirements you would be eligible to join.

Is there an enrollment fee?

No. There is no cost to join or use the card, it is free.

Once enrolled in the New York Prescription Saver Card, what will happen when I turn 65 years of age?

Two months before you turn 65 years of age, an application for the New York State Elderly Pharmaceutical Insurance Coverage (EPIC) Program will be mailed to you. EPIC provides prescription insurance coverage, which is much better than only a discount. EPIC can be used with Medicare Part D for even greater savings.
Your enrollment in the New York Prescription Saver card will end at age 65 years of age, unless you are enrolled as an individual with a disability. Individuals with a disability can continue to use the New York Prescription Saver card, but also should consider joining EPIC for greater savings.

How do I report my marital status and income?

If you are single, divorced, legally separated, widowed, or married but living apart, enter S for single on the application. Report only the income that you received last year, not any spouse's income. If you are married, enter "M" for married. If married, you must report your joint income for both spouses, even if only one spouse is applying for the card.

How do I report my income?

Your household gross income, the total income received by both you and your spouse (if married), must be reported on the application. To calculate your annual income, start with the adjusted gross income from the first page of your federal income tax form and add your non-taxable income (such as Social Security payments, tax exempt interest, etc.).

What has to be included in the annual income I report?

Household gross income is the total annual income received by you and, if married, your spouse. It includes, but is not limited to:

  • Federal adjusted gross income as reported on your income tax return;
  • Social Security income minus Medicare premiums;
  • Railroad retirement benefits;
  • The taxable amount of IRA distributions and retirement annuities;
  • Support money, including foster care support payments;
  • Supplemental Security income;
  • Tax exempt interest;
  • Worker's compensation;
  • Gross amount of loss-of-time insurance;
  • Cash public assistance and relief, other than medical assistance for the needy;
  • Non-taxable strike benefits;
  • Veterans' disability pensions; and
  • Lottery winnings.

It does not include:

  • Food stamps;
  • Medicaid;
  • Scholarships;
  • Grants;
  • Surplus Food;
  • Payments made to veterans under the Federal Veteran's Dioxin and Radiation Exposure Compensation Standards Act (Agent Orange); or
  • Payments made to individuals because of their status as victims of Nazi persecution.
I just lost my job and my health insurance coverage. My new income level is below the guidelines. Can I join New York Prescription Saver?

If you had a change in income since your last tax return, you can report your current household income on the application. Simply calculate your current monthly household income on the application using the instructions above and multiply that amount times twelve. Enter your calculated annual income on the application form. Remember that married couples need to report income from both spouses, even if only one person is joining New York Prescription Saver. Also, be aware that you must be prepared to provide documentation of your new lower income, at a later time, if required by New York Prescription Saver.

How do I calculate the amount of Social Security income to report?

To report your Social Security income, use the net amount you receive in your monthly check from Social Security and multiply it by 12 to determine your annual Social Security amount. The net amount does not include the amount of Medicare premiums that are withheld. This net amount would also be reflected in your annual award letter from the Social Security Administration or 1099 form that explains your benefits.

What income should be reported on the application of a child with a disability?

Only report income received by the child in the prior calendar year, if any. Do not include income of the parents, even when living in the same household.

What income should be reported on the application of a single adult with a disability who lives with his or her parents?

Only report income received during the prior calendar year by the single applicant; do not include income of the parents.

Can medical bills be deducted from the income reported when applying?

No. Eligibility is based on gross household income with no deductions.

Can individuals on Medicaid use the New York Prescription Saver card?

No. If you receive Medicaid, you are not eligible for the discount card. New York's Medicaid program provides comprehensive coverage of prescription and some over-the-counter medications while offering more savings than the card.

Can an individual with Medicaid spenddown use the discount card?

Yes. If the member is paying for the drug in order to meet their spenddown, they can use the New York Prescription Saver card in order to pay less for the medication.

What is an "authorized representative?"

An authorized representative is anyone you approve to apply for the discount card on your behalf. It can be a family member, a legal representative or another person who is assisting you to complete the application. If you cannot sign the application yourself, the authorized representative may sign for you. However they must enter their name and the date of their signature on the application. Remember that the certification statement requires that the applicant or their representative agree that all information provided is correct and accurate.

Section 3: Using your New York Prescription Saver Card
How do I receive my medications?

Present your New York Prescription Saver card when purchasing prescription drugs at any participating pharmacy. The pharmacist will charge you only the reduced price for your medications.

Will I ever pay more using the card than I would without the card?

Cardholders will pay the lower of the price listed on the New York Prescription Saver card or the usual retail price at the pharmacy. If the pharmacy offers special discounted prices to the public, you will not pay more than that amount when you use your card. However, some pharmacies offer their own discount card program which may have lower prices on some drugs, particularly generic drugs, than the New York Prescription Saver card. Ask you pharmacist which program has the lowest price for that particular drug.

Where can I use my New York Prescription Saver card?

Your New York Prescription Saver card can be used at all participating New York State pharmacies. To find a participating pharmacy in your city, county or zip code area, please use our Pharmacy Locator. You can find a nearby pharmacy using a name, zip code or city. If you are having difficulty finding a participating pharmacy, you can call our help desk at 1-800-788-6917.

Is there a mail order program with this card?

No. There is no mail order program included. Use your card at your local pharmacy.

What do I do if my pharmacy will not accept the New York Prescription Saver card?

If your pharmacy is not enrolled as a participating pharmacy, you can encourage them to enroll. They can call our pharmacy help desk at 1-800-785-4922 and we will send the pharmacy a contract to join the program.

Can the New York Prescription Saver card be used with other discount cards?

No. You can have other prescription coverage and still be eligible for the New York Prescription Saver Card. However, you cannot use the discount card with another prescription discount or insurance card for the same prescription.

If I am enrolled in a Medicare Part D drug plan, can I use the discount card for drugs excluded from Part D coverage?

Yes. You can use the New York Prescription Saver card to purchase prescription drugs that are not covered under Part D. This includes barbiturates, benzodiazepines, cough and cold drugs, vitamins, drugs for weight gain/loss, and cosmetic drugs.

If I am enrolled in a Medicare Part D drug plan, can I use the New York Prescription Saver card for drugs not on the plan formulary?

Yes. You can use the New York Prescription Saver card to purchase drugs that are not on your Part D plan formulary and not covered by your plan. However, it will not be credited toward your Part D out-of-pocket accumulation.

If I am enrolled in a Medicare Part D drug plan, can I use the New York Prescription Saver card during the Part D deductible or "donut hole?"

You can use the discount card instead of your Part D plan card. However, your Part D plan also provides discounted prices during the deductible or coverage gap, and you will automatically get credit toward your out-of-pocket limit. You may use your New York Prescription Saver card instead of your Part D plan, but the purchase will not automatically be credited toward your Part D out-of-pocket accumulation. You should contact your Part D plan; they may be willing to credit your discount card purchase if you send them a paper receipt.

If I am in EPIC, can I use the discount card for drugs I purchase under the EPIC deductible?

No. If you are enrolled in EPIC you may not use the New York Prescription Saver discount card for your purchases. However, you are already receiving a pharmacy discount on your EPIC deductible purchases.

Do I have to renew my card each year?

No. The card does not expire each year. However, we may request updated information from you periodically.

Last Updated: 06/10/2010