Medicare at last offers prescription drug benefits for people 65 or older. But what if you have a limited income and don't qualify for Medicare -- where can you get help?
Fortunately, there are options if you know where to look. Drug companies, state governments, and charitable organizations are helping people with low incomes afford their prescriptions.
"These programs really work," says Scott L. Parkin, vice president of communications for the National Council on Aging. "They help millions of people get medications that they couldn't otherwise afford."
To make these programs work for you, WebMD turned to some experts for advice.
Pharmaceutical Assistance Programs
Drug companies offer some of the best pharmaceutical assistance programs (PAPs), giving away medicine for free -- or at significant discounts -- to those that are eligible.
"These programs have been wonderful," says Maria Hardin, vice president of patient services at the National Organization for Rare Diseases (NORD) in Danbury, Conn. "It's now the norm that when a new drug gets approved, the company will create a program to give it away to some people who can't afford it."
Of course, not everyone is eligible. For example, some pharmaceutical companies set income caps and "the paperwork for different programs varies quite a bit," says Rich Sagall, president and co-founder of NeedyMeds, a nonprofit that provides information about financial assistance for drugs.
Sagall also warns that some health care providers may be slow in filling out the forms and "some people say that their doctors will charge them $15 for paperwork."
If that happens to you, Sagall recommends talking honestly with your doctor about your financial situation.
"If that doesn't work, I do know of some patients who have dropped their old doctor to find a new one who would not charge," he says.
Sagall points out that none of these pharmaceutical assistance programs are good for people in an emergency.
"These programs won't work in an acute situation," he says. "If you need a drug tomorrow, you're not going to get it from a PAP."
Free Prescription Drugs: Where's the Catch?
Of course, cynics might wonder why pharmaceutical companies may give away their costly drugs for free.
"Companies like to be seen as good corporate citizens," says Sagall. "They give away to these programs in the same way that they might donate to the symphony or a museum."
He also says these programs help the pharmaceutical companies advertise their medicines. And there's always the hope that uninsured people who get a drug for free might become loyal to it.
"Then later if they get insurance and can actually pay for it," Sagall says, "they will stick with the drug."
Another catch, for some, is that many PAPs require you to share financial information and that can be unnerving for people who want such information private. But Hardin, who runs the drug assistance programs for NORD, says it's often crucial.
"We have to use a financial means test," he says. "We just can't have millionaires applying for this. We have to draw the line somewhere."
Joining a Drug Assistance Program
While you can sign up directly with a drug company program, it's often a good idea to get help -- especially if you have multiple prescriptions.
Hardin estimates that most of the people she deals with are on seven to 10 medications and so may need to sign up with several drug companies. To simplify the process, several organizations can guide people toward the drug programs they need.
Some of the major ones include:
- Access to Benefits Coalition (202-479-6670) is sponsored by the National Council on Aging. The site has information about Medicare and other drug assistance plans.
- NeedyMeds (215-625-9609) provides information about drug assistance from pharmaceutical, state, and local programs, as well as programs for people with specific diseases.
- Partnership for Prescription Assistance (1-888-4PPA-NOW) offers access to more than 475 public and private patient assistance programs, including more than 180 drug company programs.
- RxAssist (401-729-3284) offers access to drug company programs.
- Rx Outreach (1-800-769-3880) directly offers generic drugs at a reduced price. "While the drugs aren't free," says Sagall, "they are very, very inexpensive."
Some sites may request personal information; others allow you to stay anonymous. If you have concerns about these or similar sites, ask your doctor for recommendations -- or do more research before using them.
More Resources for Drug Assistance
Many of the agencies above also help you find other resources for financial assistance. Some of these include:
- State government programs. Your state may offer assistance with drug costs. "Some states offer a lot and some very little," says Sagall. "Some offer help for people with some diseases and not others."
- Programs for people with specific diseases. Some charity organizations offer assistance to people with specific diseases. For instance, Hardin oversees the medication assistance programs for NORD, whose programs began as a way to provide medicine to uninsured people with certain rare diseases. But increasingly, funds have been going to people who have insurance but can't afford their co-pays, Hardin says.
To find out more about these state and charity programs, check the resources listed above, or talk to your health care provider.
You've probably heard that drugs sold in Canada -- and other foreign countries -- are cheaper than those in the U.S. While it can be true, experts urge caution.
"We don't really get into the issue of buying drugs from Canada or elsewhere because it's too fraught," says Parkin. "Our position is that there are a lot of programs here in the U.S. that people can use without having to get drugs from other countries."
Sagall, from NeedyMeds, is also wary.
"I don't advise people about getting drugs out of the country," Sagall says, who goes on to admit that "[he] would say that getting them from Canada or Great Britain is probably OK because they are countries that have safety regulations that are similar to ours."
But he does worry about discounted drugs coming from other areas in the world.
"I'm concerned about safety," he says. "You definitely want to avoid any country or organization that will send you the drug without a prescription."
Problems with the Medicare Drug Benefit
While the new Medicare drug plans have helped many people get affordable drugs, they have also been laden with problems. For example, many people have found the basic medications they have been taking for years are not covered.
Parkin argues that -- given the speed with which it was created and the political pressures exerted on it -- some problems at the beginning are to be expected, while Sagall maintains "the Medicare drug benefit [has] been a complete disaster."
One problem is that Medicare's plan and drug company assistance programs can come into conflict.
That's because most assistance programs won't accept those who qualify for other drug coverage. Unfortunately, that 'other coverage' may now include the Medicare drug benefit.
"Lots of people have relied on these drug assistance programs for a long time," says Sagall. "But now because Medicare is offering drug coverage, the drug programs are forcing them out."
The problem is that the Medicare program, in many cases, can't come close to offering the discounts -- often free drugs -- that the assistance programs could.
"A lot is going to change this year," Hardin tells WebMD. "The dust hasn't even begun to settle yet with the Medicare drug benefit."
Seeking Drug Savings? Stick With It
If you have limited resources, tracking down ways to save money on your drugs might seem overwhelming. But experts say it's worth the effort.
The best resource may be the Internet. And "talk to your doctor," Parkin says. "Or call a local agency on aging for advice."
And stay informed. It's far too early to tell how drug assistance programs, state programs, and Medicare will work together, says Hardin. The details may change a lot in the coming year.
Finally, remember that a little persistence goes a long way.
"Finding these drug discounts is not as complex as people think," Sagall says. "And these programs do work. They save people's lives. You just have to be willing to spend some time finding them."