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How To Get Free Prescriptions from Drug Companies

       

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Patient Assistance Programs

Is there really such a thing as "free drugs"?

Yes! 
Pharmaceutical companies realize that not all American residents have the resources to pay for necessary medication. In fact about 1 in 5 have no insurance and even more are underinsured.  Making a person choose between food or prescriptions isn't fair, so the pharmaceutical companies are trying to help.  These programs sponsored by the drug companies are typically called "Patient Assistance Programs" or PAPs.  Most companies have PAPs available for their newest and most expensive drugs.  Medications that have been around a long time and are made by many manufacturers usually don't have a program available.  

But are these "free medicine" programs really FREE?

Yes!

Most drug companies will send the medication for a patient free of charge.  In a few situations, the patient may be asked to pay a small co-pay, but this is not the usual practice.  For the majority of the medications you will complete an application, provide valid income documentation, mail it in and then receive the medication free, the cost being only your time and postage.

However you will find there are services available that will assist you in getting and completing the applications. While you can research the internet and find the applications for free, it is also not unreasonable to expect to pay a small fee for a service to help you.  The choice is yours, however it is not recommended you pay more than $20 per month or $5 per application for such assistance.

How do these patient assistance programs work?

These programs are really quite simple, however they do take time to become enrolled and you need to follow the company guidelines explicitly.  The general process is as follows.

Your doctor prescribes you a new prescription, something you find is quite expensive at the pharmacy.

You do your research and find the drug manufacturer has a PAP for this medication.  You obtain an application, look at it's specific criteria, and if you match, you fill out and sign the application.

You then have your doctor sign the application and sometimes provide a new prescription as well. 

You send this to the drug manufacturer.  They take 2-6 weeks to decide if you qualify for the free medication program.  If you are not approved, they should send you or your doctor a letter,  If you are approved, they will send the medication either to your doctor or to your home - depending on their specific policy.  You will need to make sure your doctor is aware they'll need to call you if it is shipped to their office. Usually 3 months supply of medicine is shipped at one time.

How do I know if I qualify for free medicine?

Specific details will vary from drug company to drug company, but there are  general guidelines most follow.

1. In most cases the patient must be a United States resident and citizen.  There are a few companies that will accept a green card.

2. Patient must not have any prescription insurance. 

This includes any drug benefit from state or federal programs or private insurances.  Again, there are a few exceptions, but that is the general rule.  It never hurts to ask a drug company if you can qualify if you have a unique situation such as insurance denial for a necessary drug.

3. Patient must fall within certain income limits. 

This varies widely between the companies, but generally speaking the maximum income is around 200% of the Federal Poverty Level. (see chart below).  Some companies are as low as 185%, some much higher.  Again, if the application doesn't specify it doesn't hurt to ask for help.  Remember, this income must be verified with submitted documentation.

I think I qualify, what are the step by step instructions to get my free prescriptions?

1.Make a list of all the medications you take, or at least the ones you want to find assistance for.  You then need to find the manufacturer of these medications.  If you don't know it, one way is to get the free list on the left side of this page.  It is a list of over 700 medications by brand name and drug company.

2. Contact the drug company to find out information on their Patient Assistance Programs. They may be able to direct you to their website, fax you an application, or mail one out to you. You can search the internet for fee-based programs to help you  (Search "free drugs") or try needymeds.com


3. Complete the patient information part of the application. Leave No Blanks!  Be sure and sign it everywhere it asks for "patient signature".

4. Take application to your doctors office for his/her signature (if required- and most do).  Be sure to talk to the office staff about calling you if your medicines are shipped there instead of your home.  Have doctor give you new, original prescription if required by company (many do require this). Make sure the prescription is for BRAND name only! Very Important - many companies will reject a prescription written for a generic name.

Most doctors are more than willing to do this to ensure their patients get the meds they need.  In fact, some clinics have staff devoted to just filling out patient assistance forms!  Ask at your doctors to see if they do, they can help save you a lot of time.

If your doctor rejects the idea of signing your application, you may want to ask the doctors nurse or assistant separately to see if he/she may be able to persuade the doctor to sign it.  It is unlikely a physician will outright refuse to do this.

5. Review entire application, including the physician information.  Make sure no information is missing from any part of the application.

6. Gather required income documentation.  All companies will require this. The 2 most acceptable forms are either last years 1040 or a copy of Social Security check/awards letter. For more types of documentation click here   Please try to be sure you fit the manufacturer guideline for income limit before applying, although it doesn't hurt to try if you're not sure.  While many companies don't disclose their specific limits, the Federal Poverty chart at the bottom of the page is a general guideline for many companies. .

Whatever number you write on the application, be sure you have the documentation to back it up.  In other words, write the exact same amount as your document says.  For example, if your SSDI check is $697.25 per month, write $697.25 on the application, do NOT write $697, $698 or $700.  It must match EXACTLY or it will likely get rejected.

7. Some companies require a letter of denial from your state medicaid organization. Be prepared to supply this, though only very few ask for this.  Another form a few companies require is a letter of termination from your last insurance company. Just be sure you find out if this is the case for the drug you are requesting so you can be prepared.  

8. COPY EVERYTHING!  Sometimes things get lost - be prepared so you can quickly send again.  Having this also helps in the refill process.

9. Double check you have all requested information such as income verification, prescriptions and all other documentation.

10. Fax or Mail it in!  Faxes are processed faster, but many companies will not accept faxes.  Look at a specific company's requirements and submit accordingly. NOTE that there are a few companies that require your doctors office to contact them.  If this is the case, make it VERY EASY for the office staff to do this.  Provide all information you've gathered above to give to the office. Some companies that require this are GlaxoSmithKline, Roche and Astellas. As stated earlier, call and get the required information so your doctors office can easily call them.

11. Check back with the patient assistance program if you have not heard from them for 2 to 3 weeks.  There may be missing information or they may not have received your application.  If they haven't made a decision yet, they'll tell you and you can check back accordingly.  It is up to you, the patient, to stay on top of this process - after all, you want your medication as soon as possible, right?

12.  If you are denied be sure to find out exactly why, and begin the reapplication process accordingly.  If your income is too high, there is probably nothing you can do about it unless your income changes. If it was simply an application error be sure to fix it and reapply.

13.  Once you are approved and receive your medications, find out what the refill process is.  Many programs require you or your doctor to call every 3 months to have the next prescription shipped.  If this is the case, mark it on your calendar 3 weeks before it is due so you don't forget to call. All companies will require new applications with documentation at least yearly, some every 3 months and some every 6 months.  If your medication manufacturer requires it every 3 to 6 months, see if you can make it easier on your doctor to sign 1 years worth of applications at one time so you can easily send it in when it is due.

Now is a good time to mention the vials you receive may be stock bottles from the manufacturer, or it may be labeled with a pharmacy prescription label just like you pick up at the drug store.  Either way, make sure you understand how to take it from your doctor.

 

VERY IMPORTANT TO REMEMBER WHEN YOU COMPLETE THE APPLICATION FOR YOUR FREE MEDICINE:

 Fill out EVERY line on the application!  Your application may be rejected for very simple reasons-even just missing a date! So put SOMETHING on every line !  If it doesn't apply to you, put N/A, None or "0" as applicable.  If you don't the drug company won't know if you forgot to fill it out or if it doesn't apply and they'll likely reject it - Don't take the chance!

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FEDERAL POVERTY TABLE FOR 2011

The federal poverty level changes for year to year, and it is slightly higher for residents of Alaska and Hawaii.

Household size represents how many people are living together are supporting each other.  If there are 2 working parents and 3 non-working children, household size is 5 and income from both parents must be considered.  If there is only one person with income and 3 dependants, household size is 4.

The percent is based on the actually poverty level.  100% FPL is what the US government has established as standard poverty.  200% FPL is 2 x that amount, and is what most drug companies use as their income limit.  250% is also included.  If a company says their income limit is 250% FPL, than household income must be AT or BELOW that amount.

48 Contiguous States and DC

 

 Household size

 100%

 133%

 150%

200%
 

 300%

400%
 

 1

$10,890

$14,484

$16,335

$21,780

$32,670

$43,560

 2

14,710

 19,564

22,065

  29,420

44,130

58,840

 3

18,530

 24,645

27,795

  37,060

55,590

74,120

 4

22,350

 29,726

33,525

  44,700

67,050

89,400

 5

26,170

 34,806

39,255

  52,340

78,510

104,680

 6

29,990

 39,887

44,985

  59,980

89,970

119,960

 7

33,810

 44,967

50,715

  67,620

101,430

135,240

 8

37,630

 50,048

56,445

  75,260

112,890

150,520

 For each additional person, add

$3,820

 $5,081

$5,730

  $7,640

$11,460

$15,280

More Questions? Please see the list of Frequently Asked Questions .

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ATTENTION CLINICS  AND PHYSICIANS: Does your office need help managing your patient assistance programs? Email

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About Seattle Rx Advocate:

The Mission of Seattle Rx Advocate is to provide assistance enabling the underinsured access to prescriptions through drug company sponsored Patient Assistance Programs.

This is accomplished through two services:

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My goal is to help, please email if I can be of assistance to you.

Karen