Many HIV patients have trouble accessing their medications. Co-pays and deductibles associated with private insurance, formulary limitations associated with state programs, and the high cost of many HIV treatment drugs can make accessing lifesaving medications very difficult.
The state AIDS Drug Assistance (ADAP) programs Many states have experiences state budgetary shortfalls that have lead to lengthy waiting lists for patients to access state ADAP programs. As of July 2011, there are over 8000 individuals in the US waiting to access state ADAP programs. However, for patients on ADAP waiting lists, a private partnership now offers a resource for accessing HIV medications.
If your patient is on an ADAP waiting list, Welvista Pharmacy can help.
Patient Assistance Programs
Many pharmaceutical drug companies have programs to provide free medications to people with no insurance, inadequate insurance, or financial difficulties. These Patient Assistance Programs (PAPs) are each individuals to the company that offers them. Each PAP has different requirements, and often requires a healthcare provider to access the program on behalf of the patient. The links below are provided to help you find the correct patient assistance program for your patients.
The Fair Pricing Coalition also publishes this printable guide to accessing patient assistance programs for HIV and Viral Hepatitis drugs.
Some Medicare beneficiaries could qualify for assistance with their prescription drug costs, and be eligible this year to pay no more than $2.50 for generic drugs and $6.30 for each brand name drug.
The steps beneficiaries can take to check if they qualify for the Medicare Low-Income Subsidy Program (also known as LIS or “Extra Help”) are simple and may be done by phone or online. Qualification is based on income (beneficiaries’ incomes must be less than $16,335 a year or $22,065 for married couples) and access to other resources.
• Medicare beneficiaries, family members, trusted counselors or caregivers can apply online in English and Spanish at www.socialsecurity.gov/prescriptionhelp.
• Beneficiaries may also call the Social Security Administration at 1-800-772-1213 (TTY users should call 1-800-325-0778) and ask for the “Application for Medicare’s Part D Extra Help.”
Medicare beneficiaries can also receive assistance in their local communities from their State Health Insurance Assistance Program (SHIP), Area Agencies on Aging (AAA), the Aging and Disability Resource Centers (ADRC) and many tribal organizations.
• For information about contacting your AAA, ADRC or SHIP go to www.eldercare.gov.
• Local SHIP contact information can be found online at www.medicare.gov/contacts/organization-search-criteria.aspx. All information provided is confidential.
To learn more about Medicare prescription drug coverage, visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Other programs for patient medication assistance reach beyond just HIV medications. Below are some links to other resources for a variety of medication assistance programs available to patients.
- RX Assist: A directory of patient assistance programs
- The Access Project: Patient assistance and co-payment programs from Housing Works
- Needy Meds: A Non-profit organization that facilitates patient assistance or drug co-pay programs for medications required to treat conditions in addition to HIV disease, e.g., medications for high cholesterol
- Together RX: Prescription savings program for uninsured individuals sponsored by many of the nation's leading pharmaceutical companies
- Partnership for Prescription Assistance: A patient assistance program run by pharmaceutical firms (1-888-4PPA-NOW)
- Positively Aware, AIDSMeds and Project Inform Hotline (1-800-822-7422): Patient-focused websites with resources for HIV patients