Programs that could provide assistance with prescription costs

The purpose of this article is to provide resources that could offer you some assistance with prescription costs. Even with a Medicare Prescription Drug Plan (Part D or Part C PDP), the cost of certain medications can be prohibitive for seniors. In 2018, each drug plan will continue to have three or four stages (levels) of coverage, with each stage providing different benefits. Some relief will be provided due to an increased benefit for both brand and generic medications during the Coverage Gap Stage, also known as the “donut hole.” (Just a point of reference to help you determine whether you will go into the Coverage Gap Stage — if you have medications with an average retail value of less than $312 per month, you will probably not go into the Coverage Gap, but will remain in the Deductible and/ or Initial Coverage wLevel for the calendar year.)

There are programs which could provide subsidies to help pay for your medications, especially if you fall into the Coverage Gap Stage; and others that may even provide free or discounted medications. Each program has rules for eligibility and varying amounts of assistance.

If you have a very costly medication with prohibitive copays, especially during the “donut hole” or Coverage Gap Stage, you should check for a program that may give you a discount or provide you with the medication free of charge. There are some websites specifically set up to help you do this. Many of the programs are income-based, or not available to anyone currently enrolled in a PDP unless you are in the Coverage Gap Stage and cannot afford the copays; however, do not let these limitations deter you from seeking assistance. There are programs that are evaluated on a caseby-case basis.

Here is a partial listing of resources that may help you find a program created to reduce your medication costs; with a brief description of each program:

Extra Help - Part D (Low Income Subsidy)

Social Security Administration website: www.socialsecurity.gov/extrahelp 1-800-772-1213 Medicare and Social Security have a program for people with limited income and resources that helps pay for your prescription drugs. This program will pay all or part of your Part D premium; will provide coverage in the coverage gap; will pay all or part of your annual deductible and most copays.

PACE/PACENET

https://pacecares.magellanhealth.com 1-800-225-7223 This is Pennsylvania’s prescription assistance program for older adults, offering lowcost prescription medications to qualified residents. You must be 65 years of age or older and a Pennsylvania resident. You cannot be enrolled in the Department of Human Service’s Medicaid prescription benefit. The application can be downloaded from the website or can be requested by calling the program. Application can also be made by phone. Eligibility is based on previous calendar year’s income. Persons with HIV or schizophrenia may be eligible for prescription coverage under the Special Pharmaceutical Benefits Program. Persons with chronic renal disease may be eligible for medication help under the Pennsylvania Department of Health Chronic Renal Disease Program. NeedyMeds Website: www.needymeds. org 800-503-6897 This program provides Program a variety of services for patients, including: links to patient assistance programs, assistance with filling out applications, and drug discount cards. The discount cards are also used for overthe-counter and pet medications. This program presents webinars on special topics and the use of their program website.

Partnership for Prescription Assistance Pennsylvania

Website: https://pa.pparx. org 1-800-955-0989 This program connects qualified people with discount or free prescription drugs, direct from the medicine manufacturer. There is also help enrolling in programs that provide medications free or at low cost. This is a single point of access to many programs.

RxAssist Website: www.rxassist.org 1-800-268-7325 Provides a comprehensive directory of Patient Assistance Programs run by companies that provide free medications to people who cannot afford to buy their medicines. This website can provide a listing of all generic name drugs in the patient assistance program database.

TogetherRx Access Website: www.togetherrxaccess.com 1-800-444-4106 This is a program, a discount card, created by many leading pharmaceutical companies to provide savings on prescription medications. You may be eligible if you do not qualify for Medicare, do not have public or private prescription drug coverage, and have a household income of up to $45,000 for a single person or $90,000 for a family of four. Medications in the program include those used to treat asthma, chronic pain, depression, diabetes, high cholesterol and many other common conditions. GoodRX Website: https://www. goodrx.com; or https://gold. goodrx.com 1-855-487-0694 This is a website that lets you compare cash prices at pharmacies for medications — it also allows a beneficiary to print off a coupon to take to the pharmacy to get their medications. To use this card, your pharmacy would have to be participating and you would pay cash instead of using your insurance. Good RX now offers a Gold Card for $9.99/month and allows up to five family members to be added to the card. It is good for people and pets.

This is not a complete listing of prescription assistance programs, but in researching these, you may find others that would work better for you. If you run into medication costs that make purchasing your prescription drugs a financial struggle, we encourage you to investigate some of these assistance programs. If you would like help with your search, you can call the assistance program directly or contact the Chester County APPRISE program (610-344-5004) to make an appointment with a counselor who will be able to help with research, and can provide the applications for any of the programs.

Mysteries of Medicare by Chester County Department of Aging Services APPRISE Program.