Medicine can be a very expensive part of your health care treatment. If your doctor has prescribed a medicine and you cannot afford to pay for it, you may be able to get the medicine for free or for a reduced cost, as there are several assistance programs that may be able to help.
Private and public health insurance
If you have health insurance, your plan may or may not pay for prescription medicine. It depends on what kind of insurance you have. For example, if you have private health insurance through your employer, some or all of the cost of your medicine may be covered. If you have the traditional Medicare plan (sometimes called fee-for-service), you’ll need Medicare Part D to make sure your medicine is covered. If you have Medicaid, the Medicaid plan in your state most likely covers the cost of prescription medicines.
State and community programs
Some state governments offer affordable medicine programs for seniors, people who are disabled and people who have low incomes. Community health centers, Area Agencies on Aging, free health clinics and other community programs may also offer help. To use these services, you may need to show that you don’t qualify for private health insurance or that you don’t make enough money to pay for your own medicine.
Some social agencies, such as the Salvation Army and some private hospitals, offer financial help for people who cannot afford prescription medicines.
Patient-assistance programs (also called PAPs) are sponsored by companies that make prescription medicine. Each company has its own rules about who qualifies for its PAP. In many cases, you will need to show that you don’t qualify for private or public health insurance (such as Medicare or Medicaid). You may also need to prove that your income is below a certain level.
Each PAP has its own application process. In many cases, your doctor, nurse or social worker will need to apply for you. For some programs, your doctor or nurse can submit an application online. For others, the application must be mailed in. It’s important to keep in mind that applying for a PAP does not guarantee that you will get your medicine for free or at a lower price.
For more information
The following Web sites can help you and your doctor find out more about assistance programs and which programs you might qualify for:
www.PPARx.orgThe Partnership for Prescription Assistance brings together America’s pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups to help qualifying patients who lack prescription coverage get the medicines they need through the public or private program that’s right for them. Many will get them free or nearly free. Among the organizations supporting this program are the American Academy of Family Physicians, the American Autoimmune Related Diseases Association, the Lupus Foundation of America, the NAACP, the National Alliance for Hispanic Health and the National Medical Association. To access the Partnership for Prescription Assistance by phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).
www.TogetherRxAccess.comThe Together Rx Access Program can help millions of Americans who have no prescription drug coverage and are not eligible for Medicare save on prescription products. Most cardholders save 25% to 40% on brand-name prescription drugs and products. Savings on generic medicines are also available. The card can be used at the majority of pharmacies. Together Rx Access Program directs individuals to the Partnership for Prescription Assistance (PPA), a clearinghouse for over 475 public and private assistance programs, including 180 offered by pharmaceutical companies.
www.needymeds.comThis Web site gives information about PAPs. The site also lists drugs that are available through PAPs and gives contact information for the companies that make them. In many cases, you can download a copy of a drug company’s PAP application. NeedyMeds also offers a free drug discount card. Just download and print the card, then bring it to your pharmacy. If your pharmacy accepts the discount card, you may receive up to 80% off the price of your prescription medicine. The NeedyMeds site also links to state Medicaid Web sites.
www.RxHope.comThis site is supported by the Pharmaceutical Research and Manufacturers of America (also called PhRMA). Using the tools on the RxHope site, your doctor can apply for you to receive free or low-cost drugs from the companies that make them.
www.rxassist.orgThis Web site is sponsored by an organization called Volunteers in Health Care. By searching the database on this Web site, you or your doctor, nurse or social worker can find out which PAPs you might qualify for. The site also gives information about other resources, such as drug discount programs.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.