Patient Assistance Programs

One common concern for many of our clients deals with the high costs of prescription drugs. Many times, our insurance plan may or may not cover our medication, and if it happens to be a non-generic type, the copay or co-insurance can be quite an eye-opener in some cases!

So what can we do about this? Well, a good option for those of us without a federal, state, or government-funded insurance program like Medicare or Medicaid, is to seek out Patient Assistance Programs (PAP’s).

For instance, let’s say you are on the medication Humira but are concerned about the high expenses you see when you get your health insurance plan’s formulary. It is important in cases like these to do a quick Google search on your brand-name medication and see if there are any such assistance programs available. With our example of Humira, it turns out they do indeed have such a program and on this specific one, there is not an income cut-off to qualify. On that note, it is important to double-check when searching, to see if there is an income limit to qualify, as some programs do require you to be at or near the Federal Poverty Line (FPL). With Humira, as long as one has commercial coverage, and meets a few other qualifications, they are likely to qualify for a savings card where the medication costs as little as $5 each time its dispensed. Not a bad deal, huh?

Now what about those of us on a government-funded insurance plan such as Medicare, Medicare Advantage, Medicare Part D, or even TRICARE? Unfortunately, we get asked this question a lot and it saddens us that many assistance programs out there tend to neglect us when we get on Medicare or Medicare plans, but our in-depth research in the past had yielded some surprising results. Let’s use another case study again. A very common prescription drug we run into here at The Harrin Group is insulin and as you may know, it can be quite costly. If for instance, someone takes Tresiba U-100 Flex Pen, this could result in a very high tier on their plan formulary, but did you know that even if you are on a Medicare Part D plan, you can possibly get additonal help? You heard that right. With the Novo Nordisk Patient Assistance Program, someone on Medicare Part D, who meets certain income limits and has spent at least $1,000 in prescription medicine costs for the year, can receive certain insulin’s like Tresiba at no cost. It goes to show that it is vital for us to check any alternatives that can limit our out-of-pocket expenses for prescription drugs.

Here at The Harrin Group in San Antonio, TX, we go the extra mile and search for programs that could benefit your healthcare needs, such as Patient Assistance Programs (PAP’s) to help with expensive medications. Whatever your individual needs are, we are here for you! Contact us today for a no obligation analysis of your situation today!

Sources: CMS, Humira, Novo Care