June 1, 2021

Access to affordable care: resources to help pay for medications

Have you or your loved ones been struggling with paying for your medications? Economic hardship has made some people face the possibility of losing their health insurance and experiencing difficulties affording their medications. You may have already heard about resources for covering HIV medication costs such as the AIDS Drug Assistance Program (ADAP), insurance, and the Ryan White HIV/AIDS Program.

What if you do not qualify for these programs? What other options do you have to pay for your medications?

If you receive HIV medical care at the HIV Care and Prevention Program Clinic, we recommend connecting with one of our social workers as a first step in exploring available options. There are several other ways to make your prescriptions more affordable, depending on your situation and the medications you need. Your care team can help you with this. Following is a summary of the options and after that more details on each of the options.

Key takeaways

  • There are patient assistance programs administered by drug companies that can help reduce the cost of or provide free medication, depending on your circumstances.

  • Good places to start are by calling 211 or checking for coupons on sites like www.goodrx.com or www.needymeds.org

  • Healthcare teams have a lot of experience in helping people explore their options. If you or someone you know is struggling with paying for medications, reach out to the office for assistance

Patient Assistance Programs (PAP)

The first place to look for help are drug Patient Assistance Programs (PAPs). PAPs are also called Assistance Programs or Patient Assistance Foundations. These programs are offered by drug companies to provide free or low-cost coverage of the drugs they manufacture. These drugs can be antiretrovirals or other classes of drugs you or your loved ones are taking.

Who can apply for PAP?

PAPs are designed for people who do not qualify for any other insurance or assistance programs such as Medicaid, Medicare, or ADAP. PAPs are also available for people who have insurance, but have high co-pay amounts or deductibles.

Not every medication has an active PAP, and programs may change from time to time.

You can search this database to see if any of your medications is eligible for a PAP https://www.needymeds.org/ and you can also talk with your pharmacist or social worker to learn more about PAPs.

What information do I need to apply for a PAP?

PAP applications are specific to each drug company; therefore, each application requirement may be different. Some common requirements for PAP are:

  • You have been prescribed a medication manufactured by the specific drug company

  • You live in the United States or a U.S. Territory

  • Verify insurance coverage, if you have any

  • You meet program income guidelines

How do PAPs assist individuals?

Different PAPs may help with medications in different ways. Here are some of the most common:

  • Reimbursement – a percentage (up to 100%) of your costs are reimbursed after you have purchased the medication and provide a receipt

  • Coupons – you will receive coupons that you can redeem at your pharmacy

  • Direct discounts at your pharmacy – the program has a direct relationship with the pharmacy and the discount is applied when you purchase the drug at a pharmacy

  • Free product – the medication is shipped directly to you

For more information about Patient Assistance Programs, go to RxAssist.org. RxAssist is a non-profit organization that keeps an updated list of PAPs.

Good Rx

GoodRx - goodrx.com - is a website you or anyone else can use to check for current prices and discounts on medications. This site can help you find the lowest cost pharmacy for your prescriptions and offers coupons to help reduce the price you pay for your prescriptions. GoodRx is a free service and most pharmacies accept coupons. The coupons must be used in place of insurance coverage.

To search for a medication, go to the below website. If you find a coupon, you can print it out, or if you have a smartphone, you can show the coupon on your phone. Your pharmacist should know how to enter the codes on the coupon to pull up the lowest discount available.

Non-profit organizations

Some non-profit organizations offer drug discount cards or free medication. There may be different programs depending on where you live. One way to find out about these programs is by calling 211.

Call 211

By calling 211, you can get information and referrals for many types of services across Wisconsin. Anyone can call 211 at any time, 24 hours a day, 7 days a week, to talk with someone. The representatives can help you find resources for health care, housing, utilities, food, employment and more, and is available in over 180 languages.

  • Call 211 or 1-877-947-2211

    • To use video relay service (VRS), dial 877-947-2211

  • Text your ZIP code to 898211

  • Live chat or search their website at 211wisconsin.communityos.org

St Vincent de Paul Charitable Pharmacy

If you or your loved ones live in Dane county, St. Vincent de Paul’s Charitable pharmacy may be able to help. If you have a current prescription, have no prescription drug insurance (including Medicare Part D plans) and meet the household-income guidelines, they might be able to fill your prescription. Although they do not stock every medication, they have many medications like antibiotics and contraceptives (birth control pills) and meds to treat common conditions such as high blood pressure and diabetes.

For more information, call the pharmacy at (608) 268-0355. Service in Spanish is available.

You can read more information on the St. Vincent de Paul website.