Several years ago, my little mama’s medical crisis dictated that she be prescribed very specific and costly medications. At 78 years old, and having been independent her entire life, she was not about to become dependent on her children due to the cost of her medications. She was a proud little lady and simply would have done without the medication rather than ask for help to pay for them. Unfortunately, the medications she was prescribed came to something like $836 a month. This was simply cost prohibitive, when you consider that her entire monthly income was a mere $914 per month. Which is where I stepped up to face the challenge facing many senior and fixed-income citizens. Now, keep in mind, this was before the days of Medicare prescription coverage, so perhaps Medicare covers a great deal of a senior citizen’s medicines these days, I don’t know. I only know that it became my personal mission to find out everything I could about obtaining for her free and reduced cost medications. My mother’s doctor was quite amazed that the programs I found were out there and asked me to help him help others of his patients whose incomes were such that they could not afford their medications.
I figured that this is some pretty good knowledge to pass along… so, if you have been prescribed costly medications which you simply cannot afford, here are some steps you can take to obtain your medications at no (or reduced) cost.
1. Start with your physician. Most physicians keep a sample closet from which they are able to dispense sample medications to their patients. They can’t dispense them indefinitely, but most can supply needy patients with a month or two of free samples in order for the patient to have time to get enrolled in the free programs. The best thing to do is get to know your physician’s secretary or medical assistant. Find out who in the office takes care of the sample medications, and seek their assistance. Let me preface all this to say that the medical assistant’s job is very difficult. Most physicians see about 40 to 50 patients, and the assistant may take a couple of hundred calls each day. They’re dealing with numerous medical and personnel, sick patients, pharmacies, other doctors, and each other, so be prepared to “wait in line” in order to get a moment of their time. Waiting patiently and being very nice will take you a long way toward getting the kind of help you need, and once you receive their help, an expression of appreciation is certainly due. This can be as simple as a smile and a sincere “thank you very much.” However, in one or two instances, where the medical assistant not only went out of her way to gather the medication (she called around to other doctors’ offices to get enough for a month’s supply), but also went out of her way to deliver it, I felt that a small plant or appreciation bud vase was in order. Again, I cannot over-emphasize the importance of being appreciative of her assistance-you will need her help as you proceed in the free meds programs, because the doctor must complete a portion of the paperwork. A good working relationship with his medical assistant can smooth the way for prompt paperwork submission.
2. Next, talk with your pharmacist about the medications being prescribed: who makes the name brand? are there generics? if so, who makes the generics? do they have an 800-number for the drug company or representative? what is the company’s website? Gather from the pharmacist all the information you can about the drug and the drug company.
3. Third, it’s time for a little research and time to hit the search engines. However, be prepared, because often the patient assistance programs for drug companies are hidden somewhere deep in the website where you might least expect them to be. Other times, it’s right there in the open, marked “Patient Assistance” or “Community Assistance” or something close to that. A great website to look at is the Pfizer Pharmaceuticals at www.pfizer.com. Pfizer’s website is very easy to use, and Pfizer is a company with a GREAT patient assistance program.
4. Once you have located the patient assistance program, you’ll either request a form online or phone the company and ask for a form. Sometimes, the patient assistant contacts will fax the form, and you’ll be able to get the program moving much faster. Find out all you can about the program and how long it may take to get your medications started. I found it took about 3 months most of the time. Your doctor will have to complete some portion of a form, as well as write a new prescription, and mail these to the pharmaceutical company.
5. You will be expected to send in a statement of income once per year. You’ll send it when you begin the program, and then each year thereafter. For Social Security, you send in the annual statement of income sent to all recipients of Social Security.
6. Once your form has been completed and your physician has completed his form and written a prescription, it must be mailed to the patient assistance program. Some companies require that the physician do it (in which case, you’ll get better service if you supply a pre-addressed, pre-stamped envelope).
That’s all there is to it. With some pharmaceutical companies, it takes only a few days from their receipt of all your paperwork to have a decision about whether you are accepted and will receive your free medication. If you are denied for any reason, don’t get upset, don’t get angry-just calmly ask the patient assistance rep how you can appeal the decision, thank them, and follow whatever steps they have outlined.
I hope this information helps you get the medication you need. I was very fortunate in that I was able to get almost all of my little mama’s medications. Rather than pay some $836 per month for meds, she paid only $23 for a generic at the local pharmacy. The patient assistance programs provided everything else. So best of luck to you in getting your meds. I would love to know how you do.
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ABOUT PATIENT ASSISTANCE PROGRAMS AND HOW THEY OPERATE:
Let me explain a little about the patient assistance programs. They all work differently. Some pharmaceutical companies join a group and have the patient assistance program administered together, like “Prescription Rx.” Others administer their patient assistance program in-house and their own personnel take care of the entire program. Some are very helpful and easy to work with; with others, it’s like fighting hornets or something.
Most of the time, they have a set household income limit. For a single member household, the income limit is usually around $18,000 to $25,000 per year. Each program is different as to their specific income limits but most are somewhere in that range.
As far as their operations, again, they all differ. Some have you complete the form and then your doctor completes his portion (and writes the prescription) and sends it directly to the pharmaceutical company. Others handle everything by fax. Most send the medications directly to the doctors’ office and you must pick them up (your doctor may be willing to mail them to you). Some send the medications directly to the patient. Some send you renewal forms every three or six months (Pfizer does this). Others expect you to keep up with your prescription expiration and call in (either to your doctor’s office or to them directly). Some will send you a year’s supply at once; others send the medications out in 3-month shipments. When you get an 800-number to call or a website to visit, these are the kinds of questions you will want to ask the patient assistance contact.
The best advice I can give you boils down to three simple things:
– KEEP A LOG OF YOUR CONTACTS: Write down the name, extension number, date, time and detail of every call you make to the drug company; this will come in very handy if your medications don’t arrive as predicted, and you’ll be happy you have this log.
– BE NICE: consistently be kind sounding-don’t grouch or grump or grumble.
– BE PERSISTENT: these programs are designed to help you but they don’t want to make it TOO easy.