Frequently Asked Questions About Patient Assistance
Programs
1. What are patient assistance
programs?
2. How do Patient Assistance Programs work?
3. Do I have to be a U.S. citizen to be eligible?
4. What are the eligibility requirements for
patient assistance programs?
5. What if I have no income for the last several
months or years?
6. What do I have to do to apply?
7. What does my doctor need to do?
8. Do I need to pay anything to participate?
9. How long does it take for my medicine to
arrive?
10. What do I do if I need a medication refill?
11. What happens if my doctor prescribes a
new medication?
12. I have health insurance, but no prescription
insurance; am I eligible for these programs?
13. I have health insurance and have reached
my limit; am I eligible for patient assistance programs?
14. I have Medicare Part D. Do I qualify for
these programs?
15. What do I do if the company decides that
I do not qualify for its patient assistance program?
16. Are there programs for generic medications?
17. Why is my medication(s) not on a patient
assistance program and, what should I do?
1) What are patient assistance programs?
A Patient Assistance Program (PAP) is
set up by drug companies that offer free or low cost drugs
to individuals who are unable to pay for their medication.
Most of the best known and commonly prescribed drugs can
be found in these programs. All of the major drug companies
have patient assistance programs, although every company
has different eligibility and application requirements.
Companies offer these programs voluntarily;
the government does not require them to provide free medicine.
There are over 2500 medications available to choose from
offered free and discounted.
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2) How do Patient Assistance Programs
work?
First, you can check to see if you qualify
for free and/or discounted prescription medications. If
you qualify you can then check to see if your medications
are available under a Patient Assistance Program. Click
Here to check eligibility and medication.
After selecting your medications, our database
will show you a medication report listing each medication.
This report will show if you are eligible by stating whether
there is a Free brand name program or a Discount
Generic program available.
Once you elect to participate you will answer specific
questions about your income and insurance and your application will be
prefilled with these answers. Then you can download your applications and print them
from your personal printer.
You and the physician must sign the application
form(s) and send them to each company. The company may send
the medication(s) to the patient's home, the physician's
office or a local pharmacy depending on the program. Some,
but not all, companies send letters informing patients and/or
physicians whether the patient has been approved for their
patient assistance program.
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3) Do I have to be a U.S. citizen to
be eligible?
Anyone in the United States can participate
in the discount generic medication programs. Only U.S. citizens
can apply for Free medications. You will be asked for a
social security number on your application for each medication.
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4) What are the eligibility requirements
for patient assistance programs?
Eligibility varies program by program.
Generally, for FREE medications, patient's must have a household
total income under 200% of the 2008 Federal Poverty Level
(that's an income below $28,000 for a family of two people),
cannot have prescription coverage from any public or private
source and must be a U.S. citizen. For Generic discounted
medications the eligibility requirements are up to 300%
income. However, there are many Free Brand name Patient
Assistance programs that have income limits higher than
200%, so it is best to check your eligibility using our
free medication database. Click
Here to check your eligibility.
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5) What if I have no income for the
last several months or years?
If you have not applied for Medicaid
in your state you should do so as soon as possible. Those
that have applied and been denied should send the denial
letter with any program applications you receive from us
to obtain your medications. Also you should attach a copy
of a Declaration of Income. Here is a form letter you can
use:
Click
Here for Declaration of Income
(You will need a doctor or social worker to sign this
form.)
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6) What do I have to do to apply?
First you must determine if you are eligible
and then check to see if your medications are available
on a program. Click
Here to check eligibility and medication availability.
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7) What does my doctor need to do?
This depends on the specific patient
assistance program. Your doctor will need to sign any applications
to authorize the medications to be shipped to the doctor's
office or direct to you. A prescription must be written
on the application or attached depending on the program
requirements. Usually the physician only has to fill out
a few brief questions on the application form and sign it.
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8) Do I need to pay anything to participate?
There is an administrative and service
fee per patient (not per drug) for our assistance with the
research and supplying your applications and information
to apply. Most patient assistance programs supply their medications
for free. A few companies with special Generic
discount programs request a $20-$30 co-pay for a 90 day
supply of medication.
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9) How long does it take for my medicine
to arrive?
It can take anywhere from 2 to 6 weeks
for medication to arrive after the company approves your
application to participate in their program. This is different
for each company that supplies medications Free or Discounted.
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10) What do I do if I need a medication
refill?
We will notify you by email several weeks
in advance of when your medicine is due to be refilled.
Refill processing depends on the program requirements. Some
companies require a new application for each refill, others
allow the doctor's office or patient to call in the request
for a refill. Every company has a specific refill policy
and our service assists you with all the information
you need to keep your medications current.
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11) What happens if my doctor prescribes
a new medication?
If you need to start the medication right
away have the doctor write one prescription for 30 days
and get that filled. Once you have enrolled in our program
you will be able to come back to the website anytime, login
and research any new medications. A medication report will
instantly tell you if your medication is on a program and
if you are eligible. You can then download and print your
application form for your new medication program.
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12) I have health insurance, but no
prescription insurance; am I eligible for patient assistance
programs?
In most programs, the answer is yes.
The main factor for eligibility is having no prescription
coverage.
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13) I have health insurance and have
reached my limit; am I eligible for patient assistance programs?
Technically, if you have reached your
coverage limit you no longer have prescription coverage,
but we suggest attaching a letter with your application
that indicates this. If you have a letter from your insurer
stating that you have used up your benefits, send that with
your applications for each medication.
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14) I have Medicare Part D. Do I qualify
for these programs?
No at this time those 65 and older and/or
eligible for or enrolled in Medicare part D do not qualify for
these Patient Assistance Programs.
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15) What do I do if the company decides
that I do not qualify for its patient assistance program?
It is up to each company to decide who
can have medication for free and who cannot. If you meet
all the eligibility requirements for the program through
our initial research you should be accepted.
For a variety of reasons, some patients are
turned down for these programs. In that case, the best thing
to do is ask your physician or health care advocate to make
an appeal directly to the manager of the patient assistance
program that explains exactly why you cannot afford to buy
your medication. We suggest a letter followed by a phone
call.
Click
here for an example of an appeal letter to a patient assistance
program - (5.15 kb Rich Text Format)
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16) Are there Patient Assistance Programs
for generic medications?
Yes. We will inform you which discount
generics are available on your report. These programs differ
from all other patient assistance programs in that they
are not offered by the pharmaceutical manufacturer of the
drug. They are programs that include many different generic
drugs which are purchased by the company and then made available
for an administrative/shipping fee to low income individuals.
Both companies have income requirements to be eligible and
both charge a fee to receive the medication.
One company offers 107 different medications
available in a 90 day supply at a cost of either $20 or
$30, depending on the medication. In order to be eligible,
your household income must be below 300% of the Federal
Poverty Level
The second company offers 97 medications and
has two pricing levels, depending on the medication: $20/$30
for a 90 day supply, $40/$60 for a 180 day supply and $80/$120
for a 360 day supply. A $3.85 shipping and handling fee
is added for each order. Your household income limit for
this program must be under 250% of the Federal Poverty Level.
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17) Why is my medication(s) not on a
Patient Assistance Program and, what should I do?
There are over 2500 medications that
are available on Free Brand Name or Discounted
Generics programs.
1) Your medication may not be made available
on a patient assistance program by the pharmaceutical companies.
These companies manufacture thousands of medications; however,
they do not offer all of them on a program. You can use
our feedback form to send us
the name of your medication to confirm if it is available
or not. We will let you know what the status is of any medication
if the medication becomes available. Please only use this
Feedback form if you want us to contact you in the future
about a medication that we have told you is not available.
You must have filled out an eligibility form requesting
research and received a report from us before using the
Feedback form.
2) Your doctor may want you to take only this
particular medication; however, there are alternative medications
that may be on patient assistance programs. You can ask
your doctor if there is an approved alternative medication.
Then you can come back to our website and research the alternative generic and brand
name. We will make every effort to advise you of any alternatives
we are aware of, but you will have to contact your doctor
to get permission to change before we will supply an application
for alternative meds.
3) You can ask your doctor if he has samples
of your medication to help you better afford future purchases.
By using our services for all or most of your medications,
obtaining either an alternative for those not available
or samples from the doctor, you will be on your way to affording
your medications that you need to be taking regularly.
RX MEDS PARTNER is dedicated to offering
the latest information available for your medication needs.
We update our list of medications weekly based on reports
from each company including new medications added, medications
removed and new application forms available.
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