There is a $35 per year enrollment fee for this program, which excludes
many persons, IMOHO.   just me, Marjorie

BENEFITS UNDER THE PROGRAM
`SEC. 1860E. (a) ACCESS TO NEGOTIATED PRICES-
`(1) IN GENERAL- An eligible entity with a contract under this part shall
provide eligible beneficiaries enrolled with the entity with access to
negotiated prices (including applicable discounts) used for payment for
prescription drugs for which coverage is not otherwise provided under this
part.
`(2) DISCOUNT CARD- An eligible entity shall issue such a card that may be
used by an enrolled beneficiary to assure the access to negotiated prices
under paragraph (1).
`(b) CATASTROPHIC BENEFIT-
`(1) IN GENERAL- Subject to paragraph (4) (relating to eligibility for the
catastrophic benefit)--
`(A) BENEFICIARIES WITH INCOME BELOW 200 PERCENT OF POVERTY LINE- In the
case of an eligible beneficiary whose income is below 200 percent of the
poverty line, the beneficiary shall not be responsible for making a payment
for a covered outpatient drug provided to the beneficiary in a year to the
extent that the out-of-pocket expenses of the beneficiary for such drug,
when added to the out-of-pocket expenses of the beneficiary for covered
outpatient drugs previously provided in the year, exceed $1,200.
`(B) BENEFICIARIES WITH INCOME BETWEEN 200 AND 400 PERCENT OF POVERTY LINE-
In the case of an eligible beneficiary whose income exceeds 200 percent but
does not exceed 400 percent of the poverty line, the beneficiary shall not
be responsible for making a payment for a covered outpatient drug provided
to the beneficiary in a year to the extent that the out-of-pocket expenses
of the beneficiary for such drug, when added to the out-of-pocket expenses
of the beneficiary for covered outpatient drugs previously provided in the
year, exceed $2,500.
`(C) BENEFICIARIES WITH INCOME ABOVE 400 PERCENT OF POVERTY LINE- In the
case of an eligible beneficiary whose income exceeds 400 percent of the
poverty line, the beneficiary shall not be responsible for making a payment
for a covered outpatient drug provided to the beneficiary in a year to the
extent that the out-of-pocket expenses of the beneficiary for such drug,
when added to the out-of-pocket expenses of the beneficiary for covered
outpatient drugs previously provided in the year, exceed $5,000.
`(2) ADJUSTMENT- The Commissioner may, as determined appropriate, annually
adjust the dollar amounts under subparagraph (A) to reflect inflation and
changes in the costs and utilization under the program over time.
`(3) ELIGIBLE ENTITY NOT AT RISK FOR CATASTROPHIC BENEFIT-
`(A) IN GENERAL- The Commissioner, not the eligible entity, shall be at
risk for the provision of the catastrophic benefit under this subsection.
`(B) PROVISIONS RELATING TO PAYMENTS TO ELIGIBLE ENTITIES- For provisions
relating to payments to eligible entities for administering the
catastrophic benefit under this subsection, see section 1860G.
`(4) CATASTROPHIC BENEFIT NOT AVAILABLE TO CERTAIN HIGH INCOME INDIVIDUALS-
`(A) IN GENERAL- An eligible beneficiary enrolled under this part whose
modified adjusted gross income for a taxable year exceeds the applicable
amount shall not be eligible for the catastrophic benefit under this
subsection.
`(B) BENEFICIARY STILL ELIGIBLE FOR DISCOUNT BENEFIT- Nothing in
subparagraph (A) shall be construed as effecting the eligibility of a
beneficiary described in such subparagraph for the benefits under
subsection (a).
`(C) PROCEDURES FOR DETERMINING MODIFIED ADJUSTED GROSS INCOME-
`(i) IN GENERAL- The Commissioner shall establish procedures for
determining the modified adjusted gross income of eligible beneficiaries
enrolled under this part.
`(ii) CONSULTATION- The Commissioner shall consult with the Secretary of
the Treasury in making the determinations described in clause (i).
`(iii) DISCLOSURE OF INFORMATION- Notwithstanding section 6103(a) of the
Internal Revenue Code of 1986, the Secretary of the Treasury may, upon
written request from the Commissioner, disclose to officers and employees
of the Medicare Prescription Drug Agency such return information as is
necessary to make the determinations described in clause (i).
Return information disclosed pursuant to the preceding sentence may be used
by officers and employees of the Medicare Prescription Drug Agency only for
the purposes of, and to the extent necessary in, making such
determinations.
`(D) DEFINITION OF APPLICABLE AMOUNT- For purposes of this paragraph, the
term `applicable amount' means--
`(i) except as otherwise provided in this subparagraph, $100,000;
`(ii) $200,000 in the case of a taxpayer who files a joint return; and
`(iii) zero in the case of a taxpayer who--
`(I) is married at the close of the taxable year but does not file a joint
return for such year; and
`(II) does not live apart from his spouse at all times during the taxable
year.
`(E) DEFINITION OF MODIFIED ADJUSTED GROSS INCOME- For purposes of this
paragraph, the term `modified adjusted gross income' means adjusted gross
income (as defined in section 62 of the Internal Revenue Code of 1986)--
`(i) determined without regard to sections 135, 911, 931, and 933 of such
Code; and
`(ii) increased by the amount of interest received or accrued by the
taxpayer during the taxable year which is exempt from tax under such Code.
`(F) DEFINITION OF JOINT RETURN- For purposes of this paragraph, the term
`joint return' has the meaning given the term in section 7701(a)(38) of the
Internal Revenue Code of 1986.
`(5) ASSURING CATASTROPHIC BENEFIT IN ALL AREAS- The Commissioner shall
develop procedures for the provision of the catastrophic benefit under this
subsection to each eligible beneficiary that resides in an area where there
are no eligible entities that have been awarded a contract under this part.