We don't stay 18 forever. We are not invincible. Life happens and the body says enough is enough. Today, with fate throwing down a frowning emoji, there are a lot of people without healthcare coverage or prescription insurance. However, resources are available to provide assistance. The industry refers to these as “patient assistance programs” and they include drug assistance programs, drug coupons, drug discount cards and government programs. Oh, and let us not forget free samples!Government Programs
One of the these programs is the Health Insurance Marketplace. The Marketplace, part of the Affordable Care Act (ACA), allows insurance companies to provide healthcare coverage for the uninsured. To familiarize you with the ACA benefits (AKA Obamacare), the Kaiser Family Foundation provides this video:
Insurance compaines must provide prescription drug coverage in their plans in order to participate in the Marketplace. Insurers are required to provide coverage for at least one drug in every category and class from the official list of approved medicines as set forth by the U.S. Pharmacopeia. Each plan has a preferred-drug list (AKA, the “Formulary”). Prices for the same medication in different formularies may vary.
Government assistance with medications can also be found under the 340B program. This program allows state or local government-run hospitals and pharmacies to provide medications at discounted prices. VisitHealth Resources and Services Administration to locate eligible health care organizations and required patient criteria.
The government prescription drug coverage program available for most people 65 and older and for people with disabilities is known as Medicare Part D. Resources here include information on how to get drug coverage, drug plans and costs. Information is also available regarding lowering drug costs during the coverage gap and a listing for Pharmaceutical Assistance Programs, which provides detailed information for specific medications. Also, drug coverage plans for patients with lower incomes can be found under Prescription Drugs at Medicaid.gov.
Programs Providing Patient Assistance
Partnership for Prescription Assistance (PPA) provides information on Medicare and Medicaid, HIV/AIDS programs, service animals and the Health Insurance Marketplace, to name a few. Information is also available about covered products, user eligibility requirements, and instructions for requesting assistance.
NeedyMeds provides information about industry-created patient assistant programs (PAPs). NeedyMeds is maintained by a non-profit organization and supplies information on PAPs along with information on medications, diagnosis, and government programs.
RxAssist provides a database of patient assistance programs along with tools, news and articles. The information is intended for patients and healthcare providers. Similar to PPA and NeedyMeds, types of patient assistance programs – along with copay cards - are provided by pharmaceutical manufacturers.
Coupons and Copay Discount Cards
GoodRx is a site that provides coupons and drug prices available at various pharmacy chains. Some coupons are accessible only by registering with GoodRx, but others are available without commitment. Drug coupons might also be obtained from the doctor or prescriber, the pharmacy, or directly from the product manufacturer's website.
Discount Cards for specific medications can also be found on the manufacturer's product web page. Locating the Discount page may not be immediately evident. Visitors to these sites may save time by searching for “assistance” or by calling the manufacturer directly. Always talk to your doctor or prescriber to determine if coupons and discount cards are a viable way to purchase your prescription.
Manufacturers provide free samples to prescribers and you should feel free to ask about sample availability, which depends on the type of medication being prescribed: A med taken once every month probably won’t be available as a sample. However, it never hurts to ask. Samples are another great way to begin a medication to see if it works for you without having to pay for it.
As always, patients should definitely speak with the doctor, prescriber and/or pharmacist about alternatives when paying for medications. Best of luck and please don’t hesitate to send in your thoughts or other patient-assistance suggestions!
- Mr. Glen, R.Ph.