Anyone know any sources for getting free/discounted pharmaceuticals?

Snapdragon

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A little background: I have psoriatic arthritis in my spine, shoulders, hips, and ankles. I went on disability at the beginning of this year (retroactive to when I applied in 2019). Once I had been on disability for 2.5 years, I was automatically enrolled in Medicare on August 1.

I am on a biologic injectable medication called Cimzia for my psoriatic arthritis. Retail price for Cimzia ranges from $5000-$7000 per month. Prior to going on Medicare, I had Anthem insurance that was part of my early retirement package. Because I had commercial insurance, I qualified for copay assistance ($0 copay) on my Cimzia. Now that I am on Medicare, I have lost the copay assistance (and my Cimzia). My Aetna medicare insurance covers the Cimzia, but my copay will be around $750/month. I cannot afford that without some sort of assistance. I have applied for Social Security low income subsidy, but because I have been careful with my money and have a bit of savings, I do not qualify. If I had squandered all my money, I would have qualified in a heartbeat.

Does anyone know of any sources, public or private, that help people on Medicare with the cost of prescription medications? This goes way beyond something like GoodRx. The GoodRx price is $4999/mo.
 

DoggyDaddy

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I don't know if the manufacturer of your medication has it, but I see commercials for various medications all the time that say, "If you are unable to afford your medication, (company name) may be able to help."
 

dvd1955

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I'm on Medicare part d and was taking a medication that cost a lot more than that. Just recently had my last dose. Hit the catastrophic coverage level the first month I was on the medication. The first month would have cost me about $3000, and about $750 per month after that. My oncology dept. is part of Community Health Network, and they have a patient advocate. She got me a grant that paid for 100% of my co-insurance for the medication.

So maybe talk to your provider (doctor) to see if they can help.
 

Snapdragon

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I'm on Medicare part d and was taking a medication that cost a lot more than that. Just recently had my last dose. Hit the catastrophic coverage level the first month I was on the medication. The first month would have cost me about $3000, and about $750 per month after that. My oncology dept. is part of Community Health Network, and they have a patient advocate. She got me a grant that paid for 100% of my co-insurance for the medication.

So maybe talk to your provider (doctor) to see if they can help.
I'm so glad that you got your medication covered. I have been in touch with the Franciscan patient advocate, and so far she says all of the grants for my medication are closed, but I'm going to keep checking.
 

dvd1955

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I'm so glad that you got your medication covered. I have been in touch with the Franciscan patient advocate, and so far she says all of the grants for my medication are closed, but I'm going to keep checking.
That's a bummer. I don't know if they do this but maybe contact Samaritan Caregivers in your area and tell them your situation. Also talk to SHIP: https://www.in.gov/ship/

These may not have funds to help you, but might have suggestion of places that might help.
 

foszoe

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Is Medicare anything like an HSA were once you meet out-of-pocket you don't have to pay that 7:50 or is that 7:50 for the whole year?
 

Snapdragon

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Medicare sucks ass, sorry. It's a huge scam.

Any chance of getting a policy through a healthcare exchange or not possible on disability?
I could look into it, but I know I'm stuck with medicare. I would have to pay for another policy besides what I have, I guess? Not sure how it would work.
 

mbills2223

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Unfortunately, those are for people with regular insurance, not medicare.
If you are on disability, you need to speak with social security about a program called extra help. Generally, most people in disability qualify...it is income driven. This lowers copays to anywhere from $0 to a max of around $9.20. If that is not the case for you, I strongly recommend calling the manufacturer directly, they often have other programs that may not necessarily be advertised that are available even for people with Medicare.
 

dvd1955

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Snapdragon, I was reading through my 2022 prescription drug plan documents, and it mentions HoosierRx, which is Indiana's pharmaceutical assistance program. Looks like you reach them through the SHIP program 800-452-4800.
 

Snapdragon

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Snapdragon, I was reading through my 2022 prescription drug plan documents, and it mentions HoosierRx, which is Indiana's pharmaceutical assistance program. Looks like you reach them through the SHIP program 800-452-4800.
Thank you. Will check it out.
 

9mmfan

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Unfortunately, those are for people with regular insurance, not medicare.
That may not necessarily be the case. Some patient assistance programs will make an exception if your co pay is an obscene amount and your income meets their requirements.
 
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