Due to recent advancements in the medicine, many diseases that were previously thought to be untreatable can now be managed with very positive success rates. The downside of this rapid advancement is that, as care improves, the cost of treatment increases, as well.

Prescription medicines are an expensive part of any treatment program. Many people find it difficult to afford the high costs of medicines; however, the promising news is that there are many organizations that help people who cannot afford to buy their prescription medication.

Prescription Assistance Program

Drug makers do offer some medicines at a lower cost or even free of cost to people who have a limited income, who are under-insured or uninsured, or who have a large family and overwhelming medical expenses. Prescription assistance programs usually are meant for people with long-term illnesses. The following are some general guidelines to determine eligibility for such a program:

• Patient should be uninsured as far as coverage for prescription medication

• Patient cannot afford the medicines

• Patient’s annual income should fall between $18,400 to $50,000 per year for a family of four

The above are general parameters; however, each organization has its own set of rules or criteria that must be met in order to receive the benefits. A good first step is to contact the healthcare provider or the primary care physician for assistance in the application process. The patient may also opt to contact the drug manufacturer directly.

This article outlines a few programs that help people to buy medication either free of cost or at reduced price.

 

Health insurance is one of the most effective ways to get coverage for many medical expenses; however, check the policy because some health insurance companies do not pay for prescription medication. It all depends on the specific insurance policy. If a person has private insurance through their employer, then some or all of their medical expenses may be covered under the policy.

Unfortunately, not everyone is eligible for private health insurance. One public health insurance option, Medicare, is health insurance coverage designed to provide coverage for people over sixty-five years of age, some people with disabilities under the age of sixty-five, and people with permanent kidney failure. The Medicare Part A covers the expenses of prescription drugs while the patient is in hospital, and Medicare Part B covers prescription drug expenses only under certain situations. Enrolling is Part C is also an option; Part C is known as Medicare Advantage and private insurance companies provide this part of the coverage. In the case of a traditional Medicare plan, or fee-for-service plan, the person might choose and enroll in Medicare Part D as part of their coverage, to make sure that their prescribed medical expenses are also covered.

Medicaid is a United States health program for eligible individuals and families with low incomes and resources; however, low income is not the only requirement to qualify for Medicaid and the specifics may vary from state to state. Medicaid is a program that is jointly funded by the state and federal governments, and is managed by the states. If the patient has Medicaid coverage, then luckily, in many states, Medicaid covers expenses for almost all prescription medication.

 

Some state government agencies offer affordable medicine program plans for senior citizens, people who have low incomes, and people with disabilities. Community health care centers, free health clinics, Area Agencies on Aging, and other community programs also offer assistance to the community.

Often, these community centers may offer a sliding scale treatment. This means that payment is based on a sliding scale, so the patient pays a more affordable amount where the cost is determined in direct ratio to their total annual income. These health care centers may also be able to provide sample medication or help the patient with applications for more substantial support. To take advantage of these programs and centers, the person must provide documentation showing that they do not possess private insurance coverage and/or they do not earn enough money to afford the cost of their medications.

 

There are private programs offered by organizations like the Salvation Army. Some private hospitals also offer financial help to people who cannot afford to buy medication.

Patient-Assistance Programs

Patient-assistance programs, or PAPs, are sponsored by the prescription drug manufacturer companies. To enjoy the benefits of low-cost medication, the patient must show the companies that they do not have insurance coverage or prove that their annual income is below a certain specified amount. Please note; every company has its own set of rules so there may be paperwork and documentation required by the patient in order to receive the benefits.

The application process for each PAP is different. In general, a doctor, nurse or social worker will apply on behalf of the person who needs the prescription medication. The drug manufacturer then sends the medicine directly to the doctor. The drug manufacturer often sends a ninety-day supply and the patient simply picks up the medicine at their doctor’s office.

For some companies, the doctor or the nurse can apply online and for other companies, medical personnel must send a hard copy of the application through the mail. Most companies do not have time limits for the drug supply and the company will usually continue to supply medication as long as the patient is still eligible for the program. Applying for a PAP does not guarantee that the person will receive the benefits, but if eligible, it is an option worth exploring because PAP provides an accessible, workable means to obtain affordable medication.

With most patient assistance programs, because they are working directly with the drug companies, the patient will often receive brand name medications. A brand name drug is defined as a newly discovered drug manufactured by a pharmaceutical company with a patent. An alternative to a brand name drug is a generic drug.

 

Generic drugs have the same active ingredients as their equivalent brand name drugs, so they are essentially clones of the brand name versions. A generic drug is equivalent to their brand name drug counterpart in terms of their dosage, strength, purity, standard, route of administration, performance, characteristic, and use, but generic drugs are often available at a much lower cost than their counterpart brand name drugs.

Generic drugs are approved by the Food and Drug Administration, or FDA. Not all brand name drugs have generic versions; therefore, the patient should check with their doctor pharmacist about the possibility of taking a less expensive generic drug instead of the costlier brand name drug.

Mail Order Pharmacies

Patients can also order their ongoing medication through direct mail to their home address. Mail order pharmacies are a great alternative, especially for on-going medications and refills needed for conditions such as diabetes, asthma, and high blood pressure. Mail order programs also have the following benefits:

• Free home delivery (some companies may charge the patient)

• Lower co-payment for prescription (with some mail-order pharmacies)

• Time and money saved by not traveling to the pharmacy each month

• Lower cost for both generic and brand name drugs

• 90-day supply may be sent at one time (this policy may vary)

• Drug and safety information sent with every order

• Benefit verification provided with order

As discussed, mail order pharmacies are often the best option for conditions requiring refills or on-going medications; however, mail order pharmacies are not as effective for a one-time illness like an infection or the flu.