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NACo Rx Discount Card Program Changes

Posted Date: 
April 2, 2012
Shantil Siaperas, Montana Association of Counties

New Agreement  |  Additional Info.

The National Association of Counties Board of Directors recently approved a new agreement with Caremark for the NACo Prescription Drug Discount Card Program.  Under the new agreement, a county can choose either the traditional model or the new revenue sharing model.  Under both programs, cards are distributed in each county and can be used by residents to receive a discount on prescriptions that are not covered by insurance, including pet medications.  

The discount cards may be used at any participating pharmacy in the US. For a complete list of participating pharmacies, please click on the following URL/link: .  Select Montana as the state, then your county from the drop down list to see the participating pharmacies in your county.

Occasionally a pharmacy will oppose this program.  If you encounter any resistance, please call Shantil Siaperas, (406)449-4360. The pharmacies are not being asked to do anything new.  They already have a PPO agreement with Caremark, so this is just an extension of an existing discount already in place.  Most pharmacies see this program as a benefit to their business.  While they may be reducing their revenue on a limited number of prescriptions, they are getting the customer in the store and while there, customers most often make additional purchases.

The NACo Discount RX Card launched in Montana in October 2005 with Cascade and Teton Counties being the first counties to participate.  Currently there are 27 counties and MACo that participate in the program.

To date, 138,091 Montana residents have saved $2,913,667 on 229,666 prescriptions, an average savings of $8.98 or 19.61% per prescription.  That is nearly $3 million that families had available for other necessities.

Participating Counties in Montana:

Beaverhead County Carbon County
Cascade County Fergus County
Golden Valley County Hill County
Judith Basin County Lewis & Clark County
Madison County McCone County
Meagher County Mineral County
Missoula County Musselshell County
Petroleum County Phillips County
Pondera County Powell County
Prairie County Ravalli County
Sanders County Stillwater County
Teton County Toole County
Treasure County Wheatland County
Yellowstone County  

For more information about the NACo RX Program, please click here or go to:

Under the optional new revenue sharing program, your county may elect to receive $1.00 per Rx filled using your county-issued cards, or you can choose to not enter into the revenue sharing agreement.  If your county is currently a participating county and you do not want to receive the revenue, no action is necessary.  If your county is currently participating and you do want to enter into the revenue sharing program, please execute the attached agreement and return to Shantil Siaperas.  We will then forward to NACo to be implemented.

The source of the revenue under the revenue sharing agreement is generally from Caremark profits, however on some prescriptions, the user will pay approximately 2% more for the prescription than residents in non-revenue sharing counties. Two percent on a $50 prescription is $1.00. On a $10 prescription, it is $0.20.  If you have concerns that your county will receive revenue while your residents will not receive the same discount, I would suggest that you earmark the revenue to a specific purpose that will benefit your residents directly.

Additionally under the new model, MACo will receive $0.40 per RX filled, and we are currently exploring the use of the NACo Rx Discount cards for county jail inmates. This has the potential to save counties thousands of dollars in inmate medical costs and when coupled with the CRS Inmate Medical Program will afford your county the greatest protection possible against inmate medical costs.

In summary, the options available are:

  • Do nothing - Your residents will not have access to discounts on non-insured prescriptions.
  • Execute the attached Participation Agreement either with or without the Revenue Sharing Rider.
Shantil Siaperas | | (406)449-4360