We often hear of people, particularly older people, who skimp when it comes to buying and taking their medications. They either take less than the prescribed amount, or completely opt out of taking of the medicines the doctor has prescribed for them. Why?…because they cannot afford them. Medication costs are one of the biggest expense’s seniors face. In many cases, it may be possible to alleviate the problem of high medication costs through assistance programs. Most people are not aware such programs are available, so please read through the information in the following paragraphs, and share it with anyone you think could benefit from it. People don’t seek help if they don’t know help exists!
LIS (Low Income Subsidy; also known as Extra Help)—This program is funded through Social Security. To qualify, you have to be on Medicare Part A, Part B, or both. If you are on SSI or QMB Medicaid, you automatically receive this benefit without having to apply. Otherwise, application is necessary. Also, for residents of Louisiana, your income as a single person cannot exceed $1,581 per month. Your savings and assets, not including your house or car, cannot exceed $14,390. If you are married, your joint income cannot be more than $2134 per month, and your savings and assets cannot be more than $28,720. If you would like assistance with the application process, Louisiana Department of Insurance has a program called SHIIP to assist applicants. If your application is approved for this benefit, you can sign up for a Part D or Advantage Plan, and it will help with, and in some cases fully cover, the drug premiums. Additionally, it will significantly lower your co-pays at the pharmacy!
Patient Assistance Programs with Drug Manufacturers—Most Drug Manufacturers offer a patient assistance program. Often your prescribing physician can assist you in applying for these programs. You can also go to the company’s website for application information. The criteria to qualify differ from company to company, but most require that, in addition to their other criteria, you have been turned down for assistance through the LIS program described above. We recommend applying even if you are not low income, because, as you are already aware, medications costs can quickly reduce your income, and most of these programs do take this into consideration.
SenioRx—What if you can’t figure out how to apply for a patient assistance program on your own? Or, what if you are overwhelmed because you have to take several expensive medications and they are all manufactured by different companies? You can receive assistance from your area’s Aging and Disability Resource Center (for Northwest Louisiana, call 800-256-3003). The staff can guide you through the process of application, and if your application is approved, they can help you coordinate the ordering of your medications through the drug manufacturers.
VA Benefit—Don’t forget that veterans (unless dishonorably discharged from service) can get many of their medications free or low cost through the VA pharmacy. They can either physically go to the closest VA pharmacy, or they can receive medications through mail order. The best way to access the VA pharmacy is through your VA clinic or physician’s office. You can also contact the VA at 877-222-8387. In general, it is still recommended that veterans get a Part D plan, so they can use it for medications that may not be provided through the VA.
If you or your loved one find yourself in a position where you cannot afford to purchase your medications, please explore the various options for help that are available. Chances are, you will qualify for some assistance. We cannot overemphasize the importance of taking all your medicines…and taking them as prescribed!
By: Bridget Lyman, Client Care Coordinator, Gilsoul & Associates, LLC