My husband is 65 years old and has high blood pressure and diabetes. The medical bills are piling up, but what's really hurting us is the cost of all his prescription medication. Is any financial help paying for prescription drugs available?
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Expert Answer by Barbara Steinberg
Barbara Steinberg is a certified financial planner, a certified estate advisor, and founder of BSA Advisors, a financial planning firm for senior citizens.Since your husband is 65, he qualifies for Medicare. If he hasn't already enrolled, he should do so immediately. Then he'll be eligible for Medicare Part D, which provides prescription drug coverage.
Under Part D, your husband will need to obtain prescription drug coverage through a private insurance provider. He'll pay a monthly premium, a deductible ($265 in 2007), and a co-payment of 25 percent of the total cost of the medication until he has spent $2,400 on prescription drugs.
After he hits the $2,400 threshold, there's a gap in coverage referred to as the "donut hole." Your husband will have to pay the full cost of the medications until his total prescription drug expenses are $3,850. Then Medicare Part D kicks in again, this time with a 5 percent co-payment. For a lot of people, the out-of-pocket expense during this gap in coverage can be crushing.
If your husband has limited financial resources, he may be eligible for reduced fees through Medicare or Medicaid. In addition, some state plans coordinate with Medicare Part D to offer low-income seniors inexpensive coverage. (Check with your state to find out whether it has such a program.)
One final option: If your husband is a veteran, he can obtain prescription drug coverage with a lower co-payment through the Veteran's Administration.
If not covered by insurance go to www.silverseniorcare.com and enroll in a FREE discount prescription drug plan. The plan is accepted at more than 40,000 pharmacies. All prescriptions are covered. Last year the average savings in the plan was 26% While at the site review the other services that are available.
Under Medicare Part D, the actual medication co-pays vary by plan (generally, the to get lower co-pays, the premium is higher). Medicare has an excellent website you should use to compare plans in your geographic area. Use the website - medicare.gov - for specific help. Click on Medicare Prescription Drug Plans; then click on Find & Compare Plans. This takes you thru a series of questions to help you find the right plan.
1-800-medicare is also a great resource.
Additionally, Medicare B pays for blood glucose testing supplies, so be sure to get this provided thru Medicare. A great resource for anything about diabetes is a Certified Diabetic Educator - most hospitals have one. Just call the hospital and ask to speak to them. They can help you arrange diabetic-related needs with your doctor.
I recommend the Medicare plublication "Medicare Coverage of Diabetes & Supplies - 11022", available on the medicare.gov website, to help sort out who pays for what.
When I worked for XYZ Drug Company we frequently offered to enroll Medicare Part D patients into the LIS or more commonly known as Extra Help program for those whose incomes were at or below the Federal Poverty Level. Many patients who qualified said their Rx cost were significanly reduced to prices most could afford on limited incomes. This program like many others does require patients to re-enroll each year. This program is administered through the Social Secuity Department and one can apply either online or in person or in some cases with the various drug manufactures. The whole process takes approximately 10 - 15 minutes if doing so with a rep who is familiar with their program.
I believe there are a lot of great options out there to help you with the situation you are in.
I was unable to keep up with the paper work through needymeds.com and even with the discount program we were paying over 100.00 a month on prescriptions.
We signed up with Prescription Assistance Programs of America. They charge $50.00 a month for unlimited prescriptions and handle all the paper work, refills and signatures. It was our best option. There website is www.simplefill.com or you can call them at 1-877-420-6496. They were great!
i have two other options you may try if those above don't do it for you...
1) I myself was surprised to learn that if you are an AAA (American Auto Association or "Triple A") member, you can present your AAA membership card at any participating pharmacy and get surprisingly good discounts on any medication. This applies only IF you have no prescription drug coverage.
2) I have also discovered that if you have access to a computer, you can make a list of every medication you use, go to the medication's website (just google it to locate the website) and find all sorts of coupons and program cards for discounts on name brand drugs. This is especially helpful for some of the newer, "designer" medications which are not available in generic.
Good luck! : )
Hi, here are some more help. i use a company called RXOUTREACH. They have about 200 drugs or more that you can get a 3 month or 6 month refill for anywhere from $20 to $35 (for 3 month) depending on what's it's for. Also, most major drug companies will help. AstraZeneca is very good. Another thing, if you need meds for stress, nerves or depression your local county mentall health dept. will supply them for about $5 a script. Best of luck! Also, the VA is an excellent option if apliciable.
