Prescription Medications: Resources for Assistance
If prescription medications are needed for asthma or severe allergies it is unusual that a health insurer will not cover them. Asthma, food allergies and some other allergies (such as to bee stings) can be life-threatening. Poorly-controlled asthma can result in high costs for ER and hospital visits. A person at risk of severe allergic reactions always needs to have an adequate supply of epinephrine devices on hand in every location where they live, work, attend school or day care, participate in athletics, etc.
People who have insurance sometimes have difficulty meeting the co-pays, either because they are high in general (due to the fact that many medications are currently available only in brand-name versions, or are placed on higher “tiers” in the list of approved medications) or because the annual deductible for out-of-pocket expenses has not yet been met.
You will need to know the name and manufacturer of the medication(s) that are needed. The organizations listed below can help direct you to how to apply for the appropriate assistance programs, may help coordinate the application, and may have other suggestions. Have available the names of your prescription medications, your income, and insurance information. For a medication that requires a prescription there will, of course, need to be documentation from your physician.
Pharmaceutical Company Programs
Many drug manufacturers have their own plans for providing free or lower cost access to their products. Contact the following, which are clearinghouses for this information. They will tell you what you need to do to request help obtaining a supply of your specific medication:
Partnership for Prescription Assistance: www.pparx.org or 1-888-477-2669
Select Care Benefits Network: www.scbn.org 888-331-1002 (For people who do NOT have Medicaid or health care insurance that covers medications. Requires a membership fee to participate.)
Epi-Pen® $0 (Zero) Co-pay program (up to $100 savings per each 2-pac; some limits): www.Epi-pen.com
Prescription Drug Discount Cards
Here are a couple of websites to look at for information about discounts. You can download discount cards with a unique code number from these websites and take them to the pharmacy to see what kind of discount is available compared to the amount your insurer is requiring you to pay at this time. Bear in mind that if the non-insurance price is lower and you purchase outside of your insurance plan it may not count toward your deductible. (Additional programs like these may be found by searching the Internet.)
Good RX: www.goodrx.com
Community Assistance Program: www.communityassistanceprogram.info
MassMedLine 1-866-633-1617 This is a free public service of the Massachusetts College of Pharmacy and Health Sciences and the Commonwealth of MA. They will assign a case manager who will work with you to see what can be done to bring down the price, determine your eligibility to apply for prescription assistance programs, and assist with the application process.