by Jill Gilbert, BAA
Millions of low-income seniors struggle financially on a daily basis, trying to make ends meet. Coupled with the exorbitant cost of prescriptions, many other necessities, like nourishing food and medical supplies, fall to the wayside. Fortunately, low-income seniors reliant on their medications have recourse – the majority of pharmaceutical companies offer 'discount medication' programs and/or prescription assistance services, provided, of course, that these seniors can prove financial hardship.
Though many low-income seniors take advantage of these incredible discount offers, many more are unaware that these prescription assistance programs exist. For eligibility information, seniors should contact the manufacturer directly; however, basic criteria for each savings program can also be found below.
AstraZeneca: For more than 30 years, AstraZeneca has offered a prescription assistance program, and in 2008 alone, AstraZeneca helped over 440,000 low-income seniors and patients fill 2.7 million prescriptions, which amounted to a savings of $600 million.
To qualify for the AZ and Me Prescription Savings program, individuals must make $30,000 or less or a family of four must make less than $60,000. Eligibility requirements also stipulate that applicants must have spent or currently be spending 3% or more of their annual income on prescriptions. AstraZeneca offers its prescription assistance program to people without insurance, people with Medicare Part D, and healthcare facilities.
AstraZeneca medicines include CRESTOR, NEXIUM, PRILOSEC, and SYMBICORT, though you can view a full list of medicines here. The website also provides a quick questionnaire to help determine eligibility in just a few moments. In addition to AZ and Me, the company also directs low-income seniors and patients to a number of other helpful prescription assistance and savings programs, including ElderCare, Associations of Clinicians for the Underserved, BenefitsCheckUp, Health Resources and Services Administration, Medicare (and My Medicare Matters), Partnership for Prescription Assistance, RxAssist, RxHope, and Rx Outreach.
Eli Lilly: In 2007, Eli Lilly donated more than $244 million in pharmaceutical products to patients and agencies in need around the world.2 With seven prescription assistance programs, Eli Lilly is dedicated to helping patients get the prescriptions they desperately need. Two of the discount medication programs, geared towards low-income seniors, are Lilly Cares and the LillyMedicareAnswers program.
Lilly Cares, in particular, is a patient assistance program that provides access to Eli Lilly products for legal U.S. residents who are uninsured and whose income is less than 200 percent of the federal poverty level. Eligibility is based on inability to pay for prescriptions as well as a lack of third-party drug payment assistance, such as Medicaid or Medicare.
To begin receiving prescription assistance benefits, patients must complete an application and have it signed by their doctor. The medication can then be picked up from your doctor's office. Medications covered by Lilly Cares include CYMBALTA, PROZAC, and ZYPREXA. Please visit www.lillycares.com [1] for more information or to download an application.
In addition to Lilly Cares, Eli Lilly also offers the LillyMedicareAnswers program, which makes medications more affordable. Eligible program participants should also be enrolled in Medicare. LillyMedicareAnswers covers FORTEO, ZYPREXA, and HUMATROPE, among many.
Other eligibility requirements include enrollment in Medicare Part D, income criteria satisfaction, low-income subsidy denial, and signed certification that medications paid for by the LillyMedicareAnswers program will not be claimed as out-of-pocket expenses. Medications are shipped to the patient's home. For more information on either Eli Lilly prescription assistance program, please call 1-877-RX-LILLY.
GlaxoSmithKline: Bridges to Access, GlaxoSmithKline's patient assistance program for non-oncology medicines, provides prescription benefits to individuals without any other insurance or third-party payment aid. Bridges to Access allows low-income seniors and patients to enroll over the phone so they can begin receiving benefits the same day.
Enrollment is necessary only once per year, though participants must have an 'advocate,' usually a doctor, to be eligible. Medicines from GlaxoSmithKline include ADVAIR, FLONASE, IMITREX, PAXIL, and ZANTAC. For a complete list, please visit http://www.bridgestoaccess.com/ProductList [2].
Low-income seniors and patients eligible for or currently enrolled in the Medicare Part D Plan can also receive benefits, though GlaxoSmithKline offers this prescription assistance program through a separate program called GSK Access.
Criteria stipulate that you must have spent at least $600 on medications through the Part D plan, are a legal U.S. resident, and your total household income is at or below 250% of the federal poverty level.3 Visit www.gsk-access.com [3] to download an application and enroll.
Merck: The Merck Patient Assistance Program was created to make medicines more affordable to everyone, whether they meet insurance criteria or not. To be eligible for the prescription assistance program, low-income seniors and patients must submit proof of financial and/or medical hardship as well as inability to pay for their prescriptions.
Applications are completed only once per year, and if accepted, medicine is provided free of charge. Merck requires that applicants are a U.S. resident, have a prescription for a Merck medicine from a licensed U.S. doctor, do not have insurance or third-party coverage options such as Medicaid and Medicare, and annual household income is less than $43,320 for individuals, less than $58,280 for couples, or less than $88,200 for a family of four.4 Medicines covered by Merck include COSOPT, COZAAR, JANUMET, JANUVIA, SINGULAIR, and TRUSOPT. For more medications that are covered by this program, please view the full list here. Or, for questions relating to the Merck Patient Assistance Program, please call 1-800-727-5400.
Pfizer: With seven prescription assistance programs, Pfizer offers low-income seniors and patients of all means the ability to get the medication they need. Four in particular, Connection to Care, FirstRESOURCE, The Pfizer Bridge Program, and Pfizer RSVP Program, all provide medications either free of charge to qualifying patients or at reduced costs through reimbursements and appeals. Eligible medications include CADUET, CELEBREX, DETROL, LIPITOR, LYRICA, and ZOLOFT.
Most of Pfizer's prescription assistance programs require that you have no prescription coverage or are eligible for a hardship exception, meet household income criteria, and are a U.S. resident. To learn more about the programs that Pfizer offers, please visit the Pfizer website to download applications and read pertinent program information.
Wyeth: Through the Wyeth Patient Assistance Program, uninsured and/or low-income seniors and patients are able to receive their prescription medications free. Though the prescription assistance program is not usually extended to patients with Medicare (or Medicare Part D), the company will evaluate situations on a case-by-case basis to determine eligibility.
To enroll, low-income seniors and patients should obtain and complete an application and privacy authorization form with help from their doctor or healthcare provider, who should also write a prescription for a one, two, or three-month supply, specifying up to three refills. The privacy authorization form should be given to the doctor, and the application and prescription write-up should be mailed to the address provided on the paperwork. Depending upon the circumstances, the medication will be mailed either to your home or your doctor's office.
For information on the Wyeth Patient Assistance Program, please call 1-800-568-9938 or visit the Wyeth website. Eligibility is determined by an individual's inability to pay for the medications, lack of insurance, annual household income is at or less than 200% of the federal poverty level, sufficient evidence of significant financial hardships, and is a resident of the U.S. or Puerto Rico. Medications covered by the prescription assistance program include EFFEXOR, ENBREL, PREMPRO, NEUMEGA, and RELISTOR.
Taking Advantage of the Programs
Usually, enrollment in any of these prescription assistance programs can be done quickly, and eligible low-income seniors and/or patients can pick up their prescriptions on a regular basis, either at no cost or at a significantly reduced price. Pharmaceutical companies know that many low-income seniors with tight budgets are unable to afford the high costs of their prescriptions, so taking advantage of these deals is not only economical but recommended to stay in the best of health.
About the Author:
Jill Gilbert is the President and CEO of Gilbert Guide, a senior care website that offers a comprehensive senior housing guide along with valuable tools and resources on caring for aging loved ones. She authors the monthly "Leading by Example" column in McKnight's Long-Term Care News, the chief industry publication for long-term care providers. Look for her book, "Gilbert Guide to Senior Housing" (Penguin/Alpha Books, 2009).
"Gilbert Guide," the leading source of senior care and aging information on the Internet, was founded on the concept that quality matters, and its primary goal is to educate consumers on a breadth of senior care issues. To learn more about finding the right senior care provider, please visit www.GilbertGuide.com [4].