Paying for Medication

I have a 15 year old son who is BP.  His medication costs per month are $1,500- 2,000.  He is on the state childs health care insurance now because our private insurance maxed out and my husband had to quit his job so we could qualify for the state’s program.  When my son turns 19 he can no longer receive the child insurance and I don’t know what to do.  He is smart and a hard worker and wants to go to college.  How do we get health insurance for him?

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Most pharmaceutical companies offer some sort of a discount program for the medications that they manufacture.  Each company differs on their qualifications and the medication included so it does require a little internet searching and/or a few phone calls.  I have listed as many links and phone numbers as I could find, so hopefully that will trim down the task a little bit.

AstraZeneca

One of the pharmaceutical companies I spoke with at the NAMI Convention was AstraZeneca.  I’ve used their program as an example of a typical pharmaceutical company program.  This is a free program with brand name AstraZeneca  medication mailed to your home, similar to a mail order pharamacy program.  You can call 1-800-AZandME or go to www.AZandMe.com to see the full list of medications as well as more details on how to apply.  The qualifications for this program:

  • If you have no prescription coverage, than you must make less than $30,000 as an individual or $60,000 for a family of 4.
  • If you have MEDICARE PART D PRESCRIPTION COVERAGE, and make less than $30,000 as an individual or less than $40,000 as a couple AND spend at least 3% of the annual household income out of pocket this year on prescription meds.   The program through AstraZeneca DOES NOT replace your current Medicare Part D plan.

Other Pharmaceutical Companies

 

 

 

 

 

 

Together Rx

Together RX is a program NOT affiliated with any particular pharmaceutical company.  This program is FREE and has more than 300 brand name prescriptions as well as a wide range of generics.  To obtain a list of the medications in their plan, you can call 1-800-250-2839, or visit their website at www.TogetherRXAccess.com.  The only requirements are the following:

  • Not eligible for Medicare
  • No prescription coverage (public or private)
  • Household income is equal to or less than:
    • $45,000 for an individual
    • $60,000 for a couple
    • $75,000 for a family of 3
    • $90,000 for a family of 4

Partnership for Prescription Assistance

This is a service that the pharmaceutical companies referred me to that will direct you to the plan that best fits your prescription needs.  It requires only a phone call or a visit to a website .  After giving the representative a list of the medications needed, they will give you all the plans that you qualify for and would work best with the medications you provided.  Some of the plans are free of charge and some may cost a minimal amount, but you can then chose a plan that best fits your needs.  You can call 1-888-4PPA-NOW or visit their website www.pparx.org  The phone call and service is free.

The  College Bound Scenarios

 If your son does go to college and attends a university, the university usually offers a health care plan as part of the tuition, at least from my experience in Illinois.  The health care plan is often a campus pharmacy and campus physicians.  Doctor visits were inexpensive ($10-$20) and medications were a certain percentage,  but it’s something I took advantage of.  If he attends a university that also has a medical school, doctor visits were minimal (even specialists) and prescriptions minimal or free.  (I attended the University of Illinois at Chicago for 2 years where they have a medical school and a hospital). 

 If your son is not planning to go to a University and will be going to community college, they often times will have information at the Admissions office on health care plans that they recommend.  If he does end up back on a private insurance plan through either yours or your husbands employer, check with the carrier.  A lot of insurance carriers will continue to cover children over age 18 if they are enrolled in college.

A final option would be to discuss the financial situation with your doctors.  My psychiatrist is out of network and I have an extremely high deductible that I would never meet in a year.  Since he is aware of my own financial situation, he has offered me a discounted rate for visits because I pay out of pocket.  He also gives me free samples of my medications every time he gets them and gives me discount cards for my medications when he has them.  The last discount card I received for one of my medications was good for 12 months and each month, the price of the medication was $25.  If you are open with your doctors,  I would think they would be willing to work with you and would rather get you the necessary medication than to be without.

 I hope  you found this information helpful.  It can seem quite overwhelming, so if you have any further questions, feel free to contact me and I can do my best to get you the information you need or further explain!   You can email me at   Christi @ askabipolar .com  (remove spaces before sending)

2 thoughts on “Paying for Medication

  1. I get my Seroquel from AstraZenca and have for about three years now. It has been a God send for sure. I am very thankful for them. Seroquel is going generic in October and the first company to make it generic charges a lot for its cost. I hope I still can continue with my current plan until other makers make the generic form of it making it less money.

  2. Shari – I would check the financial requirements for Together RX to see if you qualify for that one in the event that your current plan won’t cover it. The representatives from AstraZeneca did tell me that they only cover the brand name medication, so if there is a generic of one of their medications or when a generic becomes available, they do not cover that. (If that is the only prescription coverage you have). If you do not qualify for Together RX, I would DEFINITELY call Partnership for Prescription Assistance. You tell them the medications you are on, and they search all the plans in their database for one that matches your needs the best. You may be able to get coverage for ALL of your medications at a much cheaper rate. Both Together RX AND Partnership for Prescription Assistance cover BRAND AND GENERIC medications!!!!! 🙂 Doesn’t hurt to check it out. Together RX is free to enroll, and the medications are FREE! 🙂 Can’t hurt to check it out so you can save a few dollars to use for those doctor visits or other needs around the house!!!

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