Patient Advocacy: Healthcare on your side

Patient Advocacy: Healthcare on your side

   by Martine G. Brousse, 

Healthcare Specialist, Patient Advocate, Certified Mediator

ADVIMEDPRO

 Three Programs for Seniors 

you may never have heard of

                               (Part I: Prescription Drugs)

It is neither news nor a surprise that prescription drug costs have reached levels that render them unaffordable for too many, and especially for Seniors. Pill cutting, the late renewal of refills, non-compliance due to the inability to pay the share of cost, have become all too commonplace, jeopardizing health, creating severe or more complications and forcing many to choose between paying a pharmacy or a utility bill. 

Eventually, all of us will pick up the tab, whether in accrued Medicare payments, in a rise in ER visits or for the longer treatments of conditions once easily treatable and now chronic. 

While assistance is available through manufacturers' programs, discount cards, charitable organizations, free clinics, samples and offers, its access, and information, are often too difficult and time-consuming to track. When a medication is needed right away, who has time to contact every pharmacy in town to get the better price? 

Thanks to your tax dollars, several programs are in place to help seniors better afford these costs. Others are offered by charitable organizations Checking them out may save you time, effort and cash. 

1. Low-Income Subsidy Program ("Extra Help")

If you are already receiving Medicaid (MediCal in CA) as your secondary coverage, you have already been enrolled in this program. If you are buying your own secondary or Part D coverage, or are receiving coverage through a past employer or the US Military, you may still be eligible for low-cost prescriptions, and assistance to cover the premiums. You may qualify, based on your income, even if you are still employed. 
Drug costs for most people on this program are set at a few dollars for generic or brand-name drugs. For some, financial assistance to cover premium and/or deductible costs will be available.  
Assets such as your home, car or life insurance do NOT count toward your eligibility, though investment accounts will. Your application will be processed by the social Security Administration, which will help you choose a Part D plan if you qualify. 

For more info, visit: http://www.ssa.gov/prescriptionhelp/  or http://cms.hhs.gov/Medicare/Eligibility-and-Enrollment/LowIncSubMedicarePresCov/index.html

2. Medication Therapy Management (MTM)

Every Part D insurer is required to offer you this service. Designed to lower costs, reduce the risk of dangerous drug interactions, avoid duplication of prescriptions and therapies, educate patients to benefits, alert them of possible reactions and confirm the effectiveness and need of each treatment, this service should be used by every eligible senior, once a year. 

A pharmacist will help create an up-to-date personalized medication list, which every one of your treating physicians you should get copied on. You will get detailed information on every prescription and over-the-counter medication, including use, dosage and curative intent. Advise on when and how to best take these medications will be provided. Unnecessary, similar and ineffective treatments will be pointed out, for your physician to review. Switching to a new generic version, or stopping an obsolete treatment will save you money. 

This is an excellent time for questions, and to make sure you are getting the most appropriate and cost-effective prescriptions.  

For more info, visit: http://www.medicare.gov/part-d/coverage/medication-therapy-management/medication-therapy-programs.html  or

http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/MTM.html

3. Patient Assistance Programs ("PAPs")

Visit this website to find out about programs available in your state of residency. Search for any program, state or corporate, for your expensive prescriptions and create a up-to-date, personalized list of resources. 
This website also maintains an extensive and detailed list of all manufacturers', co-payment and saving cards programs, and are not exclusive to seniors. 

For more info, visit: 
http://www.pparx.org/en/prescription_assistance_programs/list_of_participating_programs


While other options and websites are available, these 3 suggested programs should go a long way toward helping you cover your prescription drug costs. 

©  [2016] Advimedpro.

©  [2016] Martine G. Brousse.

All rights reserved.

My objective is to offer you, the patient, concrete and beneficial information, useful tips, proven and efficient tools as well as trustworthy supportive advice as you deal with a system in the midst of sweeping adjustments, widespread misunderstandings and complex requirements. 

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