This is a familiar sentence heard from patients in these times of rising health care costs. People may be looking for employment and have no insurance, or if they do have jobs, they can’t afford their company’s health plan. And, many companies are only offering their employees high-deductible health plans. Although people on high-deductible plans have health insurance, they can’t always afford their medications.
A number of assistance programs are offered through pharmaceutical companies for people without prescription drug coverage. The general criteria for these programs are that the patients must not have insurance (although there are exceptions to this), and they must fit within the company’s income guidelines. Income guidelines are generally at or below 150-300 percent of the federal poverty level.
For most companies, the patient must fill out an application, sign it, and enclose current proof of income (federal income taxes are best). From there, the patient's doctor must sign the application, fill out the prescription portion or include a separate prescription, and agree to have the medications shipped to his/her office. Some programs allow medications to be shipped to the patient’s home, but most do not.
Once the program criteria is complete, the application must be mailed or faxed to the pharmaceutical company. Once the pharmaceutical company has evaluated and approved the application, they will mail the medication.
For people who have prescription drug coverage, but are still unable to afford their medications due to a high deductible or a very expensive medication, “Co-pay Assistance Programs” are available through pharmaceutical companies or other non-profit foundations. Not many of these types of programs are available, but they do offer help to some of the most vulnerable patients.
These programs operate similar to the patient assistance programs, but they do not always require a patient to show proof of current income, and generally they will not send free medication to the patient’s or provider’s address. Instead, they will provide some type of discount card or reimbursement. The co-pay assistance programs provided through non-profit foundations are typically geared towards a certain disease, such as diabetes or multiple sclerosis.
Medication Assistance Coordinators
We find resources to help patients pay for their medicine. If you need help with your medication costs, please call 406-329-2706.