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. Is there a fee for RxMedsAdvisor service and what is the cost of the prescription?
  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. I cannot find my medication(s) in the RxMedsAdvisor list, what should I do?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. What are patient assistance programs?

    A Patient Assistance Programs (PAP) are 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.

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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 drugs are available under a PAP program. Click Here to check eligibility and drugs.

    You will receive a report showing your eligibility for each drug and the type program. Once you elect to participate you will then receive pre-filled application(s) for the drug company program that has the medicine the patient needs.

    You or the patient and the physician must sign the form(s) and send them to each company. The drug 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 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, individuals must have incomes under 200% of the 2007 Federal Poverty Level (that's an income below $27,380 for a family of two people), cannot have prescription coverage from any public or private source and must be a U.S. resident or citizen for the Free programs. Some companies require that the patient has no health insurance.
    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 your application. 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?

    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 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.
     

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  1. Is there a fee for RxMedsAdvisor service and what is the cost of the prescription?

    Each prescription assistance program has its own set of guidelines for the cost of your actual prescriptions.  Most programs make their medications available for free some have a copay that will be outlined on the online applications. A few companies with special discount programs require a $20-$30 co-payment for a 90 day supply.
     

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  1. 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.

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  2. What do I do if I need a medication refill?

    We will notify you six 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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  3. 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.

    Then submit a new enrollment form asking us to research the new medication to see if there is a program for your medication.

    We will send you a new report with the information to obtain the new medication. You can then receive your application to process with your doctor.

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  4. I have health insurance, but no prescription insurance; am I eligible for patient assistance programs?

    In most programs, the answer is yes. A few companies, however, require that a patient has no health insurance.

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  5. 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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  6. I have Medicare Part D. Do I qualify for these programs?

    This will vary depending on the particular patient assistance program that carries your medication and that company's policy. In general, companies do not allow Part D enrollees who are eligible to receive the full low income subsidy (LIS or extra help) to apply for their programs. If you have Part D, it is a good idea to get a letter from Social Security indicating that you are not eligible for the low income subsidy.

    Although we do our best to keep Medicare eligibility information as current as possible, companies can and do make changes without notice. Companies may also be willing to review cases on a case by case basis, where financial hardship is involved. It always makes sense to call the program to check on their current policy.

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  7. 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 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.

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  8. 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 a 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 250% 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..

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  9. I cannot find my medication(s) in the RxMedsAdvisor list, what should I do?

    There are over 2500 medications that are available Free, Discounted Generics or on a Prescription Discount Card. If you have not found your medication, first check the generic and brand name in our list. Once you determine that neither the generic nor brand name is on the list there are several options:
    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 you cannot find.
    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 site to research the alternative generic and brand name.
       

RxMedsAdvisor 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.

 

 9-17-07