Resource Guide to Affordable Medications

Transcription

Resource Guide to Affordable Medications
Resource Guide to
Affordable Medications
A community based behavioral health care nonprofit organization helping people triumph over mental illness,
alcoholism, drug and other addictions. Recovery Resources serves more than 13,000 people annually.
President: Helen K. Jones, LISW
Chief Medical Officer: Richard R. Hill, M.D., Ph.D.
3950 Chester Avenue Cleveland, Ohio 44114
Phone: (216) 431-4131 Fax: (216) 431-4133
www.recovery-resources.org
This Resource Guide was made possible by generous grants from the following foundations:
How to Use the
Resource Guide to Affordable Medications
Review the Resource Guide’s Table of Contents to quickly access the scope of
services and contact information.
Contact those agencies and services listed in the Resource Guide for which you
may be eligible. Request that information be sent to you. Have a pencil and
paper ready to take notes during your phone call.
Information is generally available by phone, Internet, and/or mail.
Visit your local library for free Internet access if you don’t have a computer.
Seek additional assistance from your Primary Care Physician.
Electronic versions of the Resource Guide to Affordable Medications can be
accessed at the following websites:
Recovery Resources . . . . . . . . . . . . . . . . . . . . . . .www.recovery-resources.org
Cuyahoga County Community Mental Health Board . . . . www.cccmhb.org
Network of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.networkofcare.org
Recovery Resources appreciates Cuyahoga County Community Mental Health Board
(CCCMHB) for serving as a distribution center for the Resource Guide. Printed copies
can be requested from the CCCMHB, 1400 W. 25th Street, Cleveland, OH 44113-3199,
Phone: (216) 241-3400, ext. 365.
Disclaimer: The information contained in this Resource Guide has been provided to Recovery Resources by representatives of each
participating agency, pharmaceutical company, or service provider. Every effort has been made to accurately report correct medication
information and data. Inclusion in this Resource Guide does not endorse or exclude other possible medication treatments or alternatives.
Table of Contents
Introduction---------------------------------------------------------------------------2
Medication Assistance-------------------------------------------------------------- 3
Medications------------------------------------------------------------------3
No-Cost Meds--------------------------------------------------------------- 4
Drug Samples------------------------------------------------------ 4
Patient Assistance Programs------------------------------------- 5
PAP websites---------------------------------------------- 5
Patient Advocate Organizations------------------------ 6
Clinical Trials------------------------------------------------------ 10
Low-Cost Meds------------------------------------------------------------- 11
Governmental Programs------------------------------------------ 11
Federal Programs----------------------------------------- 12
Social Security----------------------------------- 12
Medicare------------------------------------------ 13
Medicare Advocacy Organizations--- 15
Military--------------------------------------------17
340 B Drug Pricing------------------------------18
State Programs -----------------------------------------------------19
Ohio Medicaid----------------------------------- 19
Ohio’s Best Rx----------------------------------- 20
Ohio AIDS Drug Assistance Program-------- 20
Central Pharmacy-------------------------------- 21
Local Programs------------------------------------------- 21
For-Profit Programs----------------------------------------------- 22
Patient Advocate Companies---------------------------- 22
Discount Drug Cards------------------------------------- 26
Drug Company Cards--------------------------- 27
Other Drug Cards-------------------------------- 28
Mail-Order Pharmacies---------------------------------- 30
Non-Profit Programs---------------------------------------------- 35
Co-Pay Assistance Funds-------------------------------- 35
Generics ------------------------------------------------------------ 37
Conclusion---------------------------------------------------------------------------- 40
Appendix I 2006 HHS Federal Poverty Level Guidelines ----------------- 41
Appendix II Medication List---------------------------------------------------- 41
Appendix III PAP Info Sheet ---------------------------------------------------- 53
Introduction
Dealing with a mental illness can be difficult. Whether it involves the lethargy associated with a mild depressive
disorder, or the delusions and hallucinations that accompany a severe form of schizophrenia, and everything
in between, the challenges of those who suffer with mental or emotional illnesses are significant. Finding the
most effective treatment for your unique condition adds an additional burden. But even once you’ve discovered
something that works, there is still yet another obstacle to overcome – finding a source of affordable medications.
This can be especially difficult if your disease prevents you from earning the type of income necessary to
purchase the medications you are prescribed. With the cost of a monthly supply of medications often exceeding
several hundred dollars or more, many of us are finding it difficult to pay for these necessary and often lifesaving medications. Fortunately, there are countless low-cost and even no-cost (free) programs now available
to help you acquire the medications you need. Recovery Resources, as part of its commitment to Help, Hope
and Healing, is devoted to seeking out and making these safety-net alternatives available to you in this Guide
to Affordable Medications. Feel free to take a copy for yourself and your family and to access the resources
contained in it. While some of the resources listed require internet access, many do not and can be contacted
through more traditional means; however, if you find that you need assistance with this guide, or feel that you
can assist us by informing us of other programs we may have overlooked, please don’t hesitate to contact our
Patient Advocate at (216) 781-9222. Let’s work together to find our way through the medication maze towards
personal and financial well-being.
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Medication Assistance
Medication assistance can be accessed through a variety of programs. From the free medications offered by
drug companies through their drug samples or Patient Assistance Programs (PAPs), to lower-cost medications
obtained via mail-order pharmacy or by just shopping around for generic alternatives. In the following pages
you will find these programs described along with the eligibility criteria and methods for accessing them.
Medications
There are innumerable medications available on the market today. Some drug reference manuals consume
thousands of pages attempting to list and describe them all – and new editions have to be created every year to
keep up with the changes. Given the vast number of medications as well as the fact that Recovery Resources
mission is to help people to triumph over mental illness substance abuse and other addictions, this guide will
focus primarily on relevant medications, profiled in the medication list in Appendix II. However, many of the
resources listed will also pertain to virtually any other medication available.
When accessing the medication list in Appendix II, keep in mind that those with associated no-cost and lowcost patient assistance programs available are highlighted in green and yellow respectively, and those for which
drug samples are currently available through Recovery Resources have a check box in the “Samples” column.
If your medication isn’t highlighted, be sure to check under its other names, as each is listed separately. If you
know of additional assistance programs that aren’t indicated on the list, or if you don’t see your medication on
the list at all, please contact the Patient Advocate to see if it can be added.
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No-Cost Meds
There are some programs available to help you obtain medications for absolutely no financial cost to you,
though some may require a generous helping of your time and energy.
Drug Samples
To promote their products, many of the above listed pharmaceutical companies, as well as others, provide sample medications to hospitals and clinics like Recovery Resources. These medications are then provided to you
by doctors who may be trying to help you find the best treatment, or possibly providing you temporary access
to medication in the case that you cannot afford them, do not have insurance or have not yet enrolled in one of
the programs listed below. You may find out which samples are available through Recovery Resources by
referring to the Medication list in Appendix II, or by referring to the list below:
Available Samples
Abilify
Campral
Cymbalta
Depakote
Deplin
Effexor
Emsam
Lamictal
Lexapro
Lithobid
Namenda
Paxil
Pexeva
Provigil
Requip
Risperdal
Seroquel
Strattera
Symbyax
Topamax
Wellbutrin
Zyprexa
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Patient Assistance Programs
These programs, often referred to as PAPs, are usually sponsored by the pharmaceutical companies to help people
with lower incomes obtain free medications. The eligibility criteria and application and maintenance processes
vary from program to program. You may find a comparison of programs on the PAP Info Sheet in Appendix III.
PAP Websites
Many pharmaceutical companies have a page on their website devoted to their PAP, while some even have an
associated patient assistance foundation. Following are the links to such websites for some of the companies
that manufacture mental health medications. If you don’t see the name of your drug company on this list,
however, there still may be a PAP available. Check the medication list in Appendix II or the PAP Info sheet in
Appendix III for more information.
AstraZeneca Drug Assistance
http://www.astrazeneca-us.com/content/drugAssistance/
Medications: Seroquel
Bristol-Myers Squibb Patient Assistance Foundation, Inc.
http://www.bmspaf.org/index.htm
Medications: Abilify, Emsam
Forest Pharmaceuticals, Inc. Patient Assistance Program
http://www.forestpharm.com/pap/
Medications: Campral Celexa, Lexapro
GlaxoSmithKline: Bridges To Access
http://bridgestoaccess.gsk.com/
Medications: Dexedrine, Lamictal, Parnate, Paxil, Requip, Wellbutrin, Zyban
Lilly Cares Foundation
http://www.lillycares.com/index.jsp
Medications: Cymbalta, Prozac, Strattera, Symbyax, Zyprexa
Novartis Pharmaceuticals Patient Assistance Program
http://www.pharma.us.novartis.com/novartis/pap/pap_cns_enroll.jsp
Medications: Clozaril, Focalin, Ritalin, Tegretol, Trileptal
Pfizer Helpful Answers
https://www.pfizerhelpfulanswers.com/
Medications: Dilantin, Geodon, Nardil, Navane, Neurontin, Vistaril, Zarontin, Zoloft
Takeda Patient Assistance Program
http://www.tpna.com/patasstProgram.asp
Medications: Rozerem
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Patient Advocate Organizations
In addition to the drug companies themselves, there are also other organizations devoted entirely to helping
people navigate through the Patient Assistance Program process. Some are free, and some charge a fee for
the services they provide. The free programs (“organizations”) are listed below. You may find the rest
(“Patient Advocate Companies”) on page 22.
National Organization for Rare Disorders (NORD)
Provigil Medication Assistance Program
55 Kenosia Avenue
P.O. Box 1968
Danbury, CT 06813-1968
Cephalon: (800) 675-8415
Toll-Free: (800) 999-6673
Phone: (203) 744-0100
TDD: (203) 797-9590
Fax: (203) 798-2291
Email: [email protected]
http://www.rarediseases.org/programs/medication
“NORD works closely with humanitarian-minded pharmaceutical and biotechnology companies to ensure that
certain vital medications are available to those individuals whose income is too high to qualify for Medicaid
but too low to pay for their prescribed medications. NORD’s programs have set the standards for fairness,
equity, and unbiased eligibility. The NORD programs have gained respect from the patient communities,
pharmaceutical companies, healthcare professionals, government officials, and the public. Participants have
assurance that NORD protects their confidentiality. There is no conflict of interest with respect to NORD’s
eligibility decisions.”
Benefits: The program provides qualified applicants with free vouchers, which can be used to obtain
Provigil at your pharmacy. The NORD website provides users several comprehensive indexes and databases
profiling thousands of rare disorders and organizations associated with research and treatment of those
conditions, as well as several pages that outline the various programs they offer, including their medication
assistance program.
Eligibility: You must have no other prescription coverage
Application: To apply for the program, you first call Cephalon – the drug company that manufactures the
drug – to be pre-screened. If you qualify you will be referred to NORD who will send you an application in
7-10 days. Once you complete it you may submit it to NORD, and you will receive a response from them in
4 – 6 weeks.
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Needy Meds, Inc.
P.O. Box 63716
Philadelphia, PA, 19147
Phone: (215) 625-9609
Fax: (419) 858-7221
Email: [email protected]
Website: http://www.needymeds.com/
“NeedyMeds is a 501(3)(c) non-profit with the mission of helping people who cannot afford medicine or
healthcare costs. The information at NeedyMeds is available anonymously and free of charge.”
Benefits: The Needy Meds website is a comprehensive guide to most Patient Assistance and other Programs,
from drug company PAPs and government-sponsored programs to more obscure programs for specific conditions. And their lists are each organized in different ways, so you can find programs easily. There is also other
useful info as well as a page for you to share your story.
Eligibility: Not Applicable
Application: This program provides you access to Patient Assistance Program applications, but there is no
need to apply for the program itself.
The Partnership for Prescription Assistance
Phone: (888) 4PPA-NOW (477-2669)
Website: http://www.pparx.org/Intro.php
“The Partnership for Prescription Assistance brings together America’s pharmaceutical companies, doctors,
other health care providers, patient advocacy organizations and community groups to help qualifying patients
who lack prescription coverage get the medicines they need through the public or private program that’s right
for them. Many will get them free or nearly free. Its mission is to increase awareness of patient assistance
programs and boost enrollment of those who are eligible. Through this site, the Partnership for Prescription
Assistance offers a single point of access to more than 475 public and private patient assistance programs,
including more than 150 programs offered by pharmaceutical companies.”
Benefits: The PPARX website is one of the most comprehensive and user-friendly PAP websites currently
available. Simply type in your medications, or browse their alphabetical list and select your medication
regimen. Once that is completed you will be provided a list of programs, for many of which you may apply
directly online, or you may if you call to speak with a specialist.
Eligibility: Not Applicable
Application: This program provides you access to Patient Assistance Program applications, but there is no
need to apply for the program itself.
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Rx for Ohio
Phone: (877) RX-4-OHIO (794-6446)
Website: http://www.rxforohio.org/
“Our mission is to increase awareness of and enrollment in existing patient assistance programs for those who
may be eligible. RxforOhio offers a single point of access to public and private patient assistance programs,
including more than 150 programs offered by pharmaceutical companies.”
Benefits: This organization is the Ohio branch of the Partnership for Prescription Assistance and provides the
same services but focuses primarily on programs offered in the state.
Eligibility: Not Applicable
Application: This program provides you access to Patient Assistance Program applications, but there is no
need to apply for the program itself.
RxAssist
Volunteers in Healthcare
111 Brewster Street
Pawtucket, RI 02860
Phone: (401) 729-3284
Fax: (401) 729-2955
Email: [email protected]
Website: http://www.rxassist.org
Benefits: “Through RxAssist.org, Volunteers in Health Care offers:
• A comprehensive database of pharmaceutical company patient assistance programs. RxAssist was the
first website to make application forms available online
• Extensive resources on using and understanding pharmaceutical company patient assistance programs
• Materials and information tailored to providers and consumers on medication access, including fact
sheets, FAQs and “how to” guides
• Connections to programs and professionals across the country who are wrestling with issues of
medication access, including a dynamic listserv
• Staff who are able to assist organizations starting or operating programs providing medication or
pharmacy assistance
• Staff who are able to provide a national perspective on pharmaceutical access issues and strategies”
Eligibility: Not Applicable
Application: This program provides you access to Patient Assistance Program applications, but there is no
need to apply for the program itself.
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RxHope, Inc.
PO Box 4008
Clinton, NJ 08809
Phone: (908) 713-7600
Fax: (908) 713-7700
Email: [email protected]
Website: http://www.rxhope.com
“RxHope is the only patient assistance Internet initiative financially supported by PhRMA (Pharmaceutical and
Research Manufacturers of America) and participating pharmaceutical
companies.
“RxHope began as a grassroots effort of the Patient Assistance Managers and Directors of the PhRMA-member
companies and has grown into the leading Internet-based patient assistance and sampling web portal in the
pharmaceutical industry.”
Benefits: The RxHope website provides a page from which one can search patient assistance programs by
medication, pharmaceutical company or by state. It also has a page for Healthcare Providers, which can be
used to complete applications online.
Eligibility: Not Applicable
Application: This program provides you access to Patient Assistance Program applications, but there is no
need to apply for the program itself.
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Clinical Trials
Clinical trials are conducted to answer specific health questions. Interventional trials are performed for the
purpose of testing the safety and effectiveness of experimental treatments and take place in a controlled environment. Observational trials are less restrictive and allow one to exist in their natural environment. There are
also additional subcategories into which trials are grouped. The decision to enroll in a clinical trial is not one
to be taken lightly, as the health consequences can be serious, and should only be pursued with the advice and
consent of your doctor. There are benefits to be gained by participating, however, often including access to
free, cutting-edge treatments, possibly financial compensation and, above all, the satisfaction of knowing that
your participation may help pave the way for such treatments to become more widely available to others who
suffer from conditions like your own.
International Federation of Pharmaceutical Manufacturers and Associations
Email: [email protected]
Website: http://clinicaltrials-dev.ifpma.org/
Benefits: “This service is provided by the IFPMA, on behalf of its Member Companies and Associations. The
portal has been designed as a single entry allowing you to search for comprehensive information on on-going
clinical trials (registry) or results of completed trials (database) conducted by the innovative pharmaceutical
industry.”
Eligibility: Not Applicable
Application: This program provides you information about current clinical trials, but there is no need to apply
for the program itself.
U.S. National Institutes of Health: ClinicalTrials.gov
http://clinicaltrials.gov/
Benefits: “ClinicalTrials.gov provides regularly updated information about federally and privately supported
clinical research in human volunteers. ClinicalTrials.gov gives you information about a trial’s purpose, who
may participate, locations, and phone numbers for more details. The information provided on ClinicalTrials.gov
should be used in conjunction with advice from health care professionals.”
Eligibility: Not Applicable
Application: This program provides you information about current clinical trials, but there is no need to apply
for the program itself.
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Low-Cost Meds
If you haven’t found any No-Cost meds, you still may be able to find Low-Cost meds through one or more of
the following Government and Private programs.
Government Programs
There are quite a few programs offered by the government at each of the Federal, State and Local levels. To
reduce the amount of time it would take to navigate through them all, there are several resources you can use
to discover the programs for which you are qualified.
The Cleveland Department of Aging
Phone: (216) 664-3418
“The Cleveland Department of Aging offers free Benefits CheckUps for Cleveland seniors. Benefits CheckUp
is an automated program for seniors to easily learn if they are eligible for a host of federal, state and local
assistance programs. The Cleveland Department of Aging
can assist seniors in this process.”
National Council on Aging: BenefitsCheckUp
Website: http://www.benefitscheckup.org/ or http://www.benefitscheckuprx.org/
“BenefitsCheckUp is the nation’s most comprehensive online service to screen for federal, state and some
local private and public benefits for older adults (ages 55 and over). It contains over 1,300 different programs
from all fifty states (including the District of Columbia). On average there are 50 to 70 programs available to
individuals per state.”
Even if you’re under 55, this is an excellent resource to find out about assistance programs for which you
may qualify, both for your medications (benefitscheckuprx), as well as for any other area with which you may
need financial assistance (benefitscheckup). In addition to finding programs for you, including the Medicare
Low-Income Subsidy, this website can also help you to fill out their applications.
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Federal Programs
There are several Federal governmental assistance agencies that administer programs that provide some sort of
prescription drug coverage to beneficiaries – Medicare, the Social Security Administration, the Military programs.
Social Security
Social Security Administration
Office of Public Inquiries
Windsor Park Building
6401 Security Blvd.
Baltimore, MD 21235
SSA Local Office
2519 Detroit Ave.
Cleveland, OH 44113
Toll-free: (800) 772-1213
TTY: (800) 325-0778
Website: http://www.ssa.gov
“Mission: To advance the economic security of the nation’s people through compassionate and vigilant leadership in shaping and managing America’s Social Security programs.”
Benefits: The Social Security Administration (SSA) provides supplemental security income (SSI), disability
income (SSDI), retirement, and Medicare part D low-income subsidy (LIS) benefits to qualifying applicants.
If you receive SSI or SSDI, you will usually receive state Medicaid benefits as well, which provide some prescription drug benefits (see Ohio Medicaid – page 19). If you receive SSDI benefits for 24 months, however,
you will automatically become eligible for and receive Medicare benefits. At this point, Medicaid will stop
paying for your medications and you will have to enroll in a Medicare prescription drug plan (see Medicare –
page 14). You may then apply for the Low Income Subsidy, which, if you qualify for the full or partial subsidy,
will reduce your premium and drug costs.
Eligibility: In addition to being a U.S. Citizen,
For SSI you must:
• be elderly (over 65), legally blind, or physically and/or mentally disabled
• have limited income (the amount of your benefit will vary accordingly)
• have assets of less than $2,000 if you are single, or $3,000 if you are married
For SSDI you must:
• be chronically (> 1 year) or terminally disabled and unable to work
• be under 65 (after 65 SSDI benefits convert to Retirement benefits)
• have earned enough work credits – generally, the equivalent of $40,000 lifetime earnings.
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For Retirement you must:
• have worked for 10 years
• be at least 62 years of age (the amount of your benefit will vary according to when you choose to
start receiving benefits)
For LIS you must:
• be a Medicare beneficiary and enrolled or enrolling for a Medicare prescription drug plan
• have an income of less than $14,700 if you are single or $19,800 if you are married
• have resources of less than $10,000 if you are single or $20,000 if you are married
Application: You can apply for all of these programs in person at your local SSA office, though it is recommended that you call in advance to schedule an appointment. You may also apply by phone, mail or online for
every program except for SSI.
Medicare
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244
Toll-Free: (877) 267-2323
Phone: (410) 786-3000
TTY Toll-Free: (866) 226-1819
TTY Phone: (410) 786-0727
CMS Regional Office
CMS – Region 5
233 North Michigan Avenue, Suite 600
Chicago, IL 60601
Phone: (312) 886-6432
Fax: (312) 353-0252
Website: http://www.cms.hhs.gov/
Toll-free: (800) MEDICARE (633-4227)
Website: http://www.medicare.gov
Benefits: Medicare benefits consist of:
• Part A: Hospital benefits
Ô Coverage: inpatient care, hospice care and some home health care
Ô Cost: $0 if you’ve paid Medicare taxes, $393 per month, if you haven’t
• Part B: Medical benefits
Ô Coverage: outpatient care, physical and occupational therapy, some home health care, preventive
services, medical supplies, and certain prescription drugs
Ô Cost: $98.20 per month in 2007 plus a penalty if you didn’t enroll for part B when you first
became eligible. There is also a deductible of about $130
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• Part C: Medicare Advantage
Ô Coverage: variation of Original Medicare part A and part B and part D coverage, depending on
which HMO, PPO, SNP (Special Needs Plan) or PFFS (Private Fee for Service Plan) you
choose.
Ô Costs: variable, depending on which plan you choose
• Part D: Prescription Drug benefits
Ô Coverage: prescription drugs, except for certain controlled substances such as benzodiazepines
Ô Cost: variable, depending on your prescription drug plan, your Medicaid status and your Low
Income Subsidy status (see explanation under Social Security – [section II.B.1.a.i]).
• Medigap Policies
Ô Coverage: variable portions of medicare “gaps” such as premiums, deductibles and copayments,
depending on which policy you choose v Costs: variable, depending on which policy you
choose
• Medicare Cost Plans
Ô Coverage: supplemental network of providers and services in addition to Original Medicare
Ô Costs: variable
• Demonstrations - special projects that test possible future improvements in Medicare coverage, costs,
and quality of care. They are usually population- and location-specific.
Eligibility: In addition to being a U.S. Citizen you must either:
• be over 65 – if you receive Social Security benefits enrollment will be automatic, if not you may
apply
• have been receiving SSDI benefits for 24 months
• have End Stage Renal Disease
Application: In most cases application for Medicare benefits is not only unnecessary, but impossible. The
only case in which you could apply is if you are over 65 and haven’t been receiving Social Security benefits.
This would require you to follow the application guidelines for Social Security Retirement benefits. Once you
have Original Medicare part A benefits, however, you would have to enroll for any of the other available
options noted above.
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Medicare Advocacy Organizations
Because of the size and often the complexity of the Medicare system, many organizations have developed to
ensure that beneficiaries receive the benefits they deserve. While most of the information they provide hasn’t
necessarily been reviewed or approved by Medicare, they do provide valuable alternative perspectives and
resources for some beneficiaries.
The Access to Benefits Coalition
300 D Street, SW Suite 801
Washington, DC 20024
Phone: (202) 479-6670
Fax: (202) 479-0735
Email: [email protected]
Website: http://www.accesstobenefits.org/default.aspx
“The Access to Benefits Coalition (ABC or the Coalition) is dedicated to ensuring that Medicare beneficiaries
with limited incomes know about and make the best use of all available resources for accessing prescription
drugs and reducing their costs.”
Medicare Access for Patients Rx
Email: [email protected]
Website: http://www.maprx.info/
“MAPRx is a coalition of patient, family caregiver and health professional organizations committed to safeguarding the well-being of patients with chronic diseases and disabilities under Medicare Prescription Drug
Coverage. MAPRx member organizations collaborate with national and state policymakers to ensure that beneficiaries have the access to the medication therapies they need and deserve.”
Medicare Rights Center
1030 15th Street, NW Suite 250
Washington, DC 20005
Toll-Free: (800) 333-4114
Phone: (202) 589-1316
Fax: (202) 589-1310
Website: http://www.medicarerights.org
“Medicare Rights Center (MRC) is the largest independent source of health care information and assistance
in the United States for people with Medicare. Founded in 1989, MRC helps older adults and people with
disabilities get good, affordable health care. MRC provides telephone hotline services to individuals who
need answers to Medicare questions or help securing coverage and getting the health care they need. MRC
also works to teach people with Medicare and those who counsel them–health care providers, social service
workers, family members, and others–about Medicare benefits and rights.”
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Medicare Rx Education Network
Website: http://www.medicarerxeducation.org/
“By sharing information with each other about organizations’ independent efforts, collaborating on activities,
and identifying ways to work together, the network hopes to eliminate duplication of efforts and maximize the
effectiveness of outreach efforts. The network also hopes to pre-empt any confusion about the details of the
new Medicare prescription drug coverage by making sure information disseminated about the benefit is factual
and accurately conveyed.”
The National Council on the Aging: My Medicare Matters
300 D Street, SW
Suite 801
Washington, D.C. 20024
Phone: (202) 479-1200
TDD: (202) 479-6674
E-mail: [email protected]
Website: http://www.mymedicarematters.org
“The MyMedicareMatters Web site is designed to help individuals learn more about the Medicare Prescription
Drug Coverage.The National Council on the Aging (NCOA) and the Access to Benefits Coalition (ABC) sponsor the site, with support from AstraZeneca.”
Ohio Senior Health Insurance Information Program (OSHIIP)
2100 Stella Court
Columbus, OH 43215
Phone: (800) 686-1578
Website: http://www.ohioinsurance.gov/ConsumServ/ConServIndex.asp?Menu=2
“OSHIIP provides free health insurance information and services for people with Medicare.
People covered by Medicare can get help from OSHIIP in various ways: A nationwide toll-free phone number…, volunteers and information sites near you, a speakers bureau, [the] web site,
objective, free and easy-to-read literature — including Ohio shopper’s guides.”
The State Health Insurance Assistance Program (SHIP)
Western Reserve Area Agency on Aging
925 Euclid Avenue, #600
Cleveland, OH 44113
Phone: (800) 626-7277
Website: http://www.shiptalk.org
“The State Health Insurance Assistance Program, or SHIP, is a national program that offers one-on-one
counseling and assistance to people with Medicare and their families. Through federal grants directed to
states, SHIPs provide free counseling and assistance via telephone and face-to-face interactive sessions,
public education presentations and programs, and media activities.”
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Military
U.S. Department of Veteran’s Affairs
Cleveland Regional Office
A.J. Celebrezze Federal Building
1240 E. 9th St.
Cleveland, OH 44199
Health Benefits Center Number: (877) 222-VETS (8387)
Toll-free: (800) 827-1000
Website: http://www.va.gov
Benefits: In addition to health care coverage, “honorably discharged veterans without service-connected disabilities who are enrolled with the VA generally pay $7 per prescription. Low-income vets and those with some
service-connected disabilities can get free prescription drugs at VA hospitals and pharmacies.”
Eligibility: Barring certain exceptions, in addition to being a U.S. Citizen and a veteran of the U.S. Military,
you must:
• have been honorably or generally discharged
• have enlisted prior to 1980, or have 24 months of continuous active duty military service
• be enrolled in the VA Health Care system
Application: You may obtain an application online, by calling the Health Benefits Center, or by visiting,
writing or calling any VA healthcare facility or VA Benefits Office. Once you complete the application,
you may mail it to the local VA office, along with: discharge papers, evidence of Purple Heart receipt and
subsequent hostile fire or immanent danger pay
TRICARE Pharmacy Benefit
Office of the Assistant Secretary of Defense (Health Affairs)
TRICARE Management Activity
Skyline 5, Suite 810, 5111 Leesburg Pike
Falls Church, VA 22041-3206
Toll-free: (877) 363-6337
Regional: (877) TRICARE (874-2273).
Website: http://www.tricare.osd.mil/retirees/
Benefits: “Military retirees, spouses and survivors registered with Defense Enrollment Eligibility Reporting
System can obtain prescription drugs with $3 co-pays for generics and $9 co-pays for brand-name drugs
through a national mail order program and through local retail pharmacies. Prescriptions can be filled at a military treatment facility free of charge.”
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Eligibility: You must:
• be registered with the Defense Enrollment Eligibility Reporting System (DEERS) – automatic if you
are active duty or retired military
• be a Continued Health Care Benefit Program enrollee
• be eligible for TRICARE including primarily:
Ô active duty or retired military
Ô un-remarried spouses or unmarried children of an active, retired or deceased service member
Ô abused spouses, former spouses or children of service members
Ô retired or disabled service members with Medicare part A and B
Ô Congressional Medal of Honor recipients and family members
Application: If you meet the eligibility criteria you will automatically receive TRICARE pharmacy benefits,
though you may opt to enroll in the TRICARE Mail Order Pharmacy or to enhance your standard TRICARE
benefits.
340 B Drug Pricing Program
While the above federal programs may provide you prescription assistance directly, there is also at least one
other federal program that may provide you indirect assistance with paying for your medications. The 340B
Drug Pricing Program, administered through the Health Resources and Services Administration, allows
Federally-Qualified Health Centers and other healthcare providers to obtain discounted medications through a
contracted pharmacy. Discounts can range up to 50% of the retail price, and even more if the provider is what
is called a Prime Vendor. Unfortunately, Recovery Resources has not yet enrolled in this program. However, if
you receive services from a healthcare provider that qualifies under 340B, be sure to ask them if they have
enrolled. For more information, visit: http://www.hrsa.gov/opa/introduction.htm
To search the participant database, visit: http://opanet.hrsa.gov/opa/CE/CEExtract.aspx
The following is contact information for some local participating organizations:
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Care Alliance
2221 Payne Ave.
Cleveland, OH 44114
(216) 781-6228
Lutheran Hospital
1730 W. 25th St.
Cleveland, OH 44113
(216) 363-2230
Neighborhood Family Practice
3569 Ridge Rd.
Cleveland, OH 44102
(216) 281-8945
Northeast Ohio Neighborhood
Health Services
Various
(216) 231-7700
State Programs
There are several state programs that can help you to access affordable medications. While there are additional
benefit programs, only those that provide medication assistance are profiled here.
Ohio Medicaid
The Ohio Department of Job and Family Services
30 E. Broad St., 32nd Floor
Columbus, Ohio 43215-3414
Local Office
2012 W. 25th St.
Cleveland, OH 44113-4135
Phone: (216) 556-8889
Toll-free: (800) 324-8680
Phone: (614) 466-6282
Fax: (614) 466-2815
TTY/TDD: (614) 752-3951
Website: http://jfs.ohio.gov/OHP/consumer.stm
Benefits: If you receive only Medicaid benefits (including Healthy Start/SCHIP and Healthy Families) and
your medication is on the Medicaid Drug Rebate Program formulary (as most medications are), your
medications will be paid for. If you do not qualify for Medicaid and are medication dependent you may
apply for the Disability Medical Assistance (DMA) program. If you also have Medicare, you will have to
enroll for a prescription drug plan and Medicaid will pay your premium and reduce your drug costs to under
$5 per medication. Medicaid may also pay for medications that are not be covered under your drug plan, e.g.,
controlled substances. Programs such as QMB, SLMB, QI-1, QI-2, and QWDI are additional Medicare
Premium Assistance programs.
Eligibility: You must:
• be a U.S. citizen or meet Medicaid citizenship requirements
• be an Ohio resident
• have or get a Social Security number
• meet the following financial criteria (see Appendix I)
Who's Covered?
Income Eligibility
Guidelines
Children (Up to age 19)
200% FPL
Pregnant Women
150% FPL
Families
Ohioans age 65 or older &
Individuals w/ Disabilities
90% FPL
64% FPL
Application: Submit in person at the local office. Applications may also be downloaded from the ODJFS
website listed above and mailed, however, this method is less effective.
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Ohio’s Best Rx
Ohio’s Best Rx
P.O. Box 408
Twinsburg, OH 44087-0408
Toll-free: (866) 9BEST-RX (923-7879)
TTY: (866) 763-9630
Fax: (877) 923-7879
Website: http://www.ohiobestrx.org/
Benefits: This program provides a discount pharmacy card which can result in savings of up to 10 - 25% for
brand name drugs and 20 – 45% for generics. A prescription mail order option is available as well.
Eligibility: You must:
• be an Ohio resident
• have an income of less than 250% of the poverty level (see Appendix I)
• have no prescription drug coverage
Application: Call the toll-free number or visit the website to obtain an application. Once complete, you may
submit it via fax or mail.
Ohio AIDS Drug Assistance Program
Ohio Ryan White Title II Program
Ohio Department of Health
HIV CARE Services Section
246 North High Street, 6th floor
P.O. Box 118
Columbus, OH 43216-0118
Phone: (800) 777-4775
AIDS Hotline: (800) 332-2437
Website: http://www.odh.ohio.gov/odhPrograms/chss/aids/drugasst/drgasst1.aspx
Benefits: Though this program is a payer of last resort and has stringent criteria, it provides mail-order
medications from a specialty order pharmacy, free of charge, to qualified enrollees. A drug formulary is
available at the above website. Two refills are allowed on each prescription and the doctor must call in a new
prescription every 3 months. Enrollment is for a year at a time and requires documentation of income and a
physician’s report as well as an updated application each period. If you don’t qualify, for this program but still
need assistance the Ohio Dept. of Health also offers the Health Insurance Premium Payment (HIPP) program,
as well as the Ohio Medicaid Spenddown Payment (OHMSDP) program for individual with HIV/AIDS.
Eligibility: You must:
• be a resident of Ohio
• be HIV positive
• have income of less than 500% of the Federal Poverty Level (see Appendix I).
• provide proof of income and IRS tax transcript
• provide physician verification of HIV infection, medication list and lab results from within the last
6 months
Application: An application for this program may be downloaded from the above website, or you may call the
toll-free number for more information about these programs and the application process for them.
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Central Pharmacy
Ohio Department of Mental Health
Office of Supportive Services
Central Pharmacy Outpatient
2150 West Broad Street
Columbus, OH 43223
Phone: (614) 751-0150
Website: http://www.mh.state.oh.us/oss/general/oss.cpoutpatient.html
Benefits: If you don’t qualify or are in the process of applying for any of the other programs featured in this
guide, or have run out of medications, you may qualify to receive medications temporarily through Central
Pharmacy for a small administrative fee of $10 per prescription.
Eligibility: You must:
• have an income of less than 100% of the Federal Poverty Level (see Appendix I).
• be in the process of finding and applying for other assistance programs.
Application: Ask your doctor about the program if you think you qualify and you may be set up with an
appointment to meet with the Patient Advocate.
Local Programs
Cuyahoga Meds-For-Less
Phone: (866) 310-9657
Website: http://www.cuyahogacounty.us/home/pdf/medsforless.pdf
Benefits: “If you need help lowering the cost of prescription drugs, Cuyahoga Meds-For-Less has five ways to
help you SAVE:
• FREE Prescription Discount Card: Every Cuyahoga County resident, regardless of income, who does not
already have a prescription plan, can save 5% - 40% on the retail cost of drugs at most neighborhood and
chain pharmacies countywide.
• U.S. Mail Order Program: Every Cuyahoga County resident, regardless of income, who does not already
have a prescription plan, can save 20% - 60% off the retail cost of drugs they need on a regular basis by
enrolling in our mail order program.
• $7 Prescription Assistance Program: If you meet certain income guidelines, we will work with your doctor
to provide your prescription at $7 per prescription (per month), plus a $25 annual fee. THERE ARE NO
OTHER COSTS. Please have your medical information and proof of income (such as Social Security dis
ability or IRS tax form) ready BEFORE you call.
• RxforOhio: Go to www.rxforohio.org to see a list of programs offered by the State of Ohio to cut the cost
of prescriptions.
• Medicare Part D Assistance: If you have questions about the Medicare Part D prescription drug plan, we
can help.”
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Eligibility: You must:
• be a resident of Cuyahoga County
• not have prescription drug coverage
Application: You may access any of the above programs by calling the phone number and enrolling directly
over the phone.
For-Profit Programs
There are several programs offered by for-profit companies to help reduce the cost of prescription drugs.
They include patient advocate companies, discount drug cards and mail order pharmacies.
Patient Advocate Companies
Cuyahoga Meds-for-Less
(see page 21)
Free Medicine Foundation
P.O. Box 125
Doniphan, MO 63935-0125
Phone: (573) 996-3333
Website: http://www.freemedicinefoundation.com
http://www.themedicineprogram.com
“Our mission at Free Medicine Foundation is to connect you and your loved ones with programs that will help
you save or eliminate prescription medicine costs. Enrollment in a patient assistance program eases the drain
on family funds, resulting in increased cash available for life’s basic necessities.”
Benefits: For a $5 refundable fee per prescription, this organization will wade through the PAP application
process for you. You simply provide them a list of your medications, and within 2 – 3 weeks you will receive
the medications or a coupon to be redeemed at a pharmacy. If you are a Recovery Resources client, the Patient
Advocate can provide these services for you.
Eligibility: See Appendix III for eligibility criteria
Application: You may download an application from the website, or call the phone number to have one sent
to you. After you submit it to them with the fee by mail, they will send you a customized packet of PAP
applications, which you would then give to your doctor to complete and submit to the appropriate PAP. If
you are approved, the medications will be shipped to your doctor’s office. If you are denied, simply send the
foundation your denial letter and they will refund your fee.
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Free Medicine Program
P.O. Box 630217
Miami, FL 33163-0217
Phone: (800) 921-0072
Fax: (866) 705-0121
Website: http://www.freemedicineprogram.com/
“Our goal at FREE Medicine Program is to: Find the appropriate Patient Assistance Program(s) for you.
Provide you with the latest, most complete and accurate application information. Simplify the rules, guidelines
and procedures. Expedite the submission process, by preparing your customized submission package. Guide
and assist you in your application process.”
Benefits: The Free Medicine Program helps you to navigate through the PAP application process for a flat $5
refundable fee. Their website also has a searchable list of medications that feature assistance programs.
Additionally, there is a virtual health library, pharmacy locator as well as news and updates. If you are a
Recovery Resources client, the Patient Advocate can provide these services for you.
Eligibility: You must:
• have no other prescription drug coverage
• be unable to afford your out-of-pocket medication expenses
Application: You may download an application from the website, or call the phone number to have one sent to
you. You may also submit your application directly from the website. After you submit it to them with the fee,
they will send you a customized application packet, which you would then give to your doctor to complete and
submit to the appropriate PAP. If you are approved, the medications will be shipped directly to you. If you are
denied, simply send the foundation your denial letter within 90 days of your initial application date and they
will refund your fee.
Health Med Assist, Inc.
4659 South 2300 East Suite 203
Salt Lake City, UT 84117
Phone: (801) 277-9769
Toll Free: (877) 277-9769
Email: [email protected]
Website: http://www.healthmedassist.com/
“Health Med Assist, Inc. is a patient advocate organization that provides two services: It works with pharmaceutical companies to establish the eligibility of applicants, It continues an ongoing application process that
assures continuing medication to needy applicants.”
Benefits: This organization helps you to apply for Patient Assistance Programs for an initial $25, non-refundable research fee plus an ongoing $10 per-prescription-per-month maintenance fee. If you are a Recovery
Resources client, the Patient Advocate can provide these services for you.
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Eligibility: See Appendix III for eligibility criteria.
Application: Call the phone number to request an application packet. It will be mailed to you for completion.
Once you return it to the company with the non-refundable $25 research fee, you will be informed about the
available PAPs within 1 – 2 weeks and the applications will be sent directly to your doctor. Once your doctor
submits the forms and you are officially approved to receive medications, they will be shipped to your doctor’s
office, and you will then be responsible for submitting the $10 per-prescription-per-month maintenance fee and
notifying the company when your medications have arrived.
Med-Solutions
684 Church St.
Santa Rosa, CA 95905
Phone: (707) 579-3924
Fax: (808) 356-0501
Website: http://www.freemedsandsolutions.com/
“Our Focus at Free Meds and Solutions is to provide you and your loved ones with programs that will save or
eliminate prescription medicine costs ,as well as a number of associated assistance programs. Our site is
designed to assist you in accessing the 100’s of Patient Assistant Programs. We provide the most up-to-date
information, qualifying criteria when available , applications and detailed instructions for these programs. We
are available to you and your Physician with quick responses to any question that you or your Physician may have.”
Benefits: You may search available patient assistance programs for free at the Med-Solutions website. For a
$10-per-medication fee, or possibly less if it would cause financial hardship, this company will send you
detailed step-by-step instructions and an application for the medication you specify. They also provide ongoing
PAP support. If you are a Recovery Resources client, the Patient Advocate can provide these services for you.
Eligibility: See Appendix III for eligibility criteria
Application: You may go to the website to order applications, for which you may pay by credit card through
their secured site. The applications will be mailed to you along with instructions, which you may follow to
submit the application for processing.
Medical Discounts International
322 Paseo Tesoro
Walnut, CA 91789
Phone: (888) 380-MEDS (6337), x 205
Email: [email protected]
Website: http://www.wecaremedicalmall.org/383.htm
“When you can’t afford your prescription medicines, there is an established free medication program available
through the pharmaceutical industry. Last year, the free medication program gave more than a billion dollars
worth of free medicine to people with limited resources. For only a $5 per medication (one-time processing
fee), we will help you obtain free medications, and we offer a money back guarantee!”
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Benefits: Like other such organizations, this organization can assist you to apply for PAPs for a refundable
fee of $5 per medication, and then handle the management of your account, including ordering refills and
renewing as necessary. If you are a Recovery Resources client, the Patient Advocate can provide these
services for you.
Eligibility: You must:
• have no other prescription drug coverage
• have a good relationship with your doctor
• be unable to afford to pay your out-of-pocket medication expenses
Application: You may download an application from the website, call the phone number to have one sent to
you, or apply directly from the website. After you submit it to them with the fee, they will send you a customized packet of PAP applications, which you would then give to your doctor to complete and submit to the
appropriate PAP. If you are approved, the medications will be shipped to your doctor’s office. If you are
denied, simply send the foundation your denial letter and they will refund your fee, minus a $2 processing fee.
Patient Assistance Services
P.O. Box 407
Marion, OH 43302
Toll-free: (877) 463-1905
Phone: (740) 223-1501
Website: http://www.patientassistanceservices.com
“Patient Assistance Services has grown to be one of the largest patient advocate companies in the United
States. We handle every aspect of the pharmaceutical companies’ “Patient Aid Programs,” from the initial qualification/application procedures through the ongoing renewal process.”
Benefits: This company charges a one-time, nonrefundable $25 set-up fee and $50 per month membership for
all of your prescription medications. Medications are mailed to your doctor’s office, a local pharmacy or your
home depending on the requirements of the pharmaceutical program. Members can also have access to a mail
order pharmacy and receive a discount card for prescriptions, vision care, chiropractic services, dental procedures, hearing aids, vitamins and home medical supplies. Aside from the discount cards and the mail order
pharmacy, if you are a Recovery Resources client, the Patient Advocate can provide these services for you.
Eligibility: See Appendix III for PAP eligibility criteria. The rest of the company’s programs are available to
everyone.
Applications: You may download an application from the website, or call the phone number to have one sent to
you. After you submit it to them with the fee by mail, they will send you quotes from US and Canadian mail
order pharmacies as well as a customized PAP applications packet, which you would then give to your doctor
to complete and submit to the appropriate PAP. If you are approved, the medications will be shipped according
to the PAP’s specifications.
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Discount Drug Cards
Though there are now fewer discount drug cards than there were immediately preceding implementation of
Medicare part D, there are still a number of them available, offered both through drug companies, independent
companies as well as through the government (see Ohio’s Best Rx and Cuyahoga Meds-for-Less above). Be
discerning in your choice to utilize any drug card, however, keeping in mind that many of these companies are
for-profit and may not be solely motivated by charitable intentions. You may want to ask yourself some of the
following questions from http://www.rxassist.org/faqs/drug-discount-cards.cfm
Eligibility:
ÔIs there an income limit? (Do you qualify?)
ÔIs there an age limit? (Do you qualify?)
ÔDo you have to be a member of an association to get this discount?
ÔDoes the plan cover you alone, you and your spouse, or your entire family?
Costs:
ÔIs this plan for medication only or is it part of health, vision and/or dental coverage?
ÔIs there a membership/enrollment/annual fee?
ÔIs there a monthly fee?
ÔWhat are your co-payments?
ÔAre there additional shipping and handling fees?
ÔWill the money you save be more than the money you spend on enrollment fees, co-payments, and other
fees?
Benefits:
ÔAre drugs provided through a mail-order pharmacy or a walk-in pharmacy?
ÔDo you have to use a "participating pharmacy?" (Are these convenient to you?)
ÔAre the drugs you need covered by the plan?
ÔWhat drugs are not covered by the plan?
ÔDoes the plan cover both generic and brand name drugs?
ÔIs the % discount the same for generic and brand name drugs?
ÔIs the discount off the retail price? (Make sure the plan is really saving you money compared to what you
would normally pay at your local pharmacy.)
ÔIs there a limit on the benefits you can receive in a year?
Protection:
ÔDoes the plan make available detailed description of coverage? (Make sure you get and read through all
the written material regarding the discount card program)
ÔDoes the plan have a customer service number, preferably one that is toll-free?
ÔWhat are the options for canceling this card? What is the policy on refunding your fees?
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Drug Company Cards
Merk Prescription Discount Program
Toll-free: (800) 50-MERCK (506-3725)
Website: http://www.merckhelps.com/uninsured/about.html
“The Merck Prescription Discount Program is simple and convenient and will make an immediate difference in
the lives of millions of Americans by helping them obtain access to Merck medicines.”
Benefits: This program offers a discount card that results in savings of between 15% and 40% on most Merck
medications.
Eligibility: You must:
• be a U.S. Resident
• not have any prescription drug coverage
Application: To obtain an application, you may call the number above to have one mailed to you, or you may
visit the website to either download it or fill it out online.
Together Rx Access, LLC
P.O. Box 9426
Wilmington, DE 19809-9944
Phone: (800) 444-4106
Website: http://www.togetherrxaccess.com/
“Thousands of eligible hardworking people with no prescription drug coverage are now saving on the
medicines they need with the Together Rx Access™ Card.”
Benefits: This program provides a discount card for over 275 medications from 12 participating drug companies. Discounts varies from 25% to 40%, depending on the manufacturer and whether the drug is generic or
brand name.
Eligibility: You must:
• have an income of less than $30,000 (individuals) or $40,000 (couples)
• have no prescription drug coverage
Application: You may call to apply over the phone, or you may access the website to apply directly online or
to download an application to submit by mail.
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Other Drug Cards
The following are a few of the many private companies that offer drug cards. Though these drug cards all
appear to come without strings attached, be sure to answer the above questions before requesting your card.
BenefitHouse Insurance Services
957 Avir Court
Gahanna, Ohio 43230
Toll-free: (866) 205-0380
Phone: (614) 933-8554
Website: http://www.benefithouse.com/free_prescription_card/default.html
“The Consumer Drug Card discount drug card from BenefitHouse can save you up to 75% on your prescription
drugs (prescription drugs discounts may vary by drug ). Both brand name prescription drugs as well as generic
prescription drugs can be purchased with the Consumer Drug Card discount drug card from BenefitHouse. You
can save at pharmacies such as Target, CVS, Medicine Shoppe, Walgreens, Kmart, Eckerd Drugs, Rite Aid,
Krogers, Wal-Mart and many more. If you’re on Medicare or your health insurance doesn’t cover prescription
drugs or you have no prescription insurance, you can start saving today on your prescription drugs.”
Benefits: This drug card provides savings of up to 75% on your brand name and generic medications. You
may use it at most chain pharmacies.
Eligibility: Not Applicable
Application: To obtain your free discount card, you simply access the website, fill in your information and
print the card out directly.
Free Drug Card.us
Email: [email protected]
Website: http://www.freedrugcard.us/index.php
“This FREE DRUG CARD program is being sponsored by a non-profit organization to help all Americans cut
their prescription drug costs. Simply download your FREE Prescription Drug Card and receive savings of up to
75% at more than 50,000 national and regional pharmacies. Participating pharmacies include the following:
Walgreens, CVS, Rite Aid, Target, Winn Dixie, SAV-ON, Eckerd, Kroger, Costco, Publix, Safeway, Phar-Mor
and Osco, as well as thousands of independent pharmacies.”
Benefits: This drug card provides savings of up to 75% on your brand name and generic medications. You
may use it at most chain pharmacies and some independent pharmacies.
Eligibility: Not Applicable
Application: To obtain your free discount card, you simply access the website, fill in your information and
print the card out directly.
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Rx Help for You
Select Benefits Global Marketing Group
P.O. BOX 62507
Cincinnati, OH 45262-0507
11006 Reading Road, Suite 301,
Cincinnati, OH 45241-1929
Phone: (513) 563-9010
Toll-free: (800) 613-4841
(888) 636-2378
Fax: (513) 956 5522
Toll-free fax: (877) 329-7246
Website: http://www.rxhelpforyou.com/
Benefits: This company offers a drug card with which you and your family may save 18% - 25% on average,
and up to 65% on all prescriptions. It also provides links to mail order pharmacies.
Eligibility: Not Applicable
Application: To obtain your free discount card, you simply access the website, fill in your information and
print the card out directly.
Mail Order Pharmacies
There are a number of mail order pharmacies, located both within the U.S. and internationally-based. The benefits of using the services of these companies usually amount to lower drug costs, sometimes resulting in savings of up to 90%, with most hovering around 50%. In addition, there is the convenience of having the medications arrive at your home. However, before you decide to utilize any of these services, please thoroughly
explore the health legal implications, and take note of this warning from the drug enforcement agency
(http://www.deadiversion.usdoj.gov/consumer_alert.htm)
29
Mail Order Pharmacies
There are a number of mail order pharmacies, located both within the U.S. and internationally-based. The benefits of using the services of these companies usually amount to lower drug costs, sometimes resulting in savings of up to 90%, with most hovering around 50%. In addition, there is the convenience of having the medications arrive at your home. However, before you decide to utilize any of these services, please thoroughly
explore the health legal implications, and take note of this warning from the drug enforcement agency
(http://www.deadiversion.usdoj.gov/consumer_alert.htm)
DEA Warning–Buying drugs online may be illegal and dangerous!
Federal law prohibits buying controlled substances such as narcotic pain relievers (e.g., OxyContin®, Vicodin
®), sedatives (e.g., Valium®, Xanax®, Ambien®), stimulants (e.g., phentermine, phendimetrazine, Adderall®,
Ritalin®) and anabolic steroids (e.g., Winstrol®, Equipoise®) without a valid prescription from your doctor.
This means there must be a real doctor-patient relationship, which by most state laws requires a physical
examination. Prescriptions written by “cyber doctors” relying on online questionnaires are not legitimate under
the law.
Buying controlled substances online without a valid prescription may be punishable by imprisonment under
Federal law. Often drugs ordered from rogue websites come from foreign countries. It is a felony to import
drugs into the United States and ship to a non-DEA registrant.
Buying drugs online may not be only illegal, but dangerous. The American Medical Association and state
boards of medicine and pharmacy have all condemned the practice of cyber doctors issuing online prescriptions
as unacceptable medical care. Drugs delivered by rogue websites may be the wrong drugs, adulterated or
expired, the wrong dosage strength, or have no dosage directions or warnings.
DEA is targeting rogue online pharmacies for prosecution and shutting down these illegal websites.
See the results of one such investigation, Operation Cyber Chase, at
www.usdoj.gov/dea/pubs/pressrel/pr042005.html.
How to spot a rogue pharmacy: www.DEAdiversion.usdoj.gov/faq/internetpurch.htm
To report illegal prescription drug sales and/or rogue pharmacies operating on the Internet call the anonymous
Pharmaceutical Drug Abuse Hotline: 1-877-RxAbuse (1-877-792-2873)
Drug Store.com
Phone: (800) 378-4786
http://www.drugstore.com/pharmacy
“drugstore.com, inc. (www.drugstore.com) is a leading online drugstore and information site for health, beauty,
wellness, personal care, and pharmacy products. The drugstore.com online store provides a convenient, private,
and informative shopping experience that encourages consumers to buy products essential to healthy everyday
living.”
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Benefits: This company allows you to shop their formulary online for better prices on your medications, and to
have them shipped directly to you.
Eligibility: Not Applicable.
Application: No application is necessary, however you must create an online account and login before you may
purchase medications online. A prescription from your doctor is necessary.
Generic Medicine Program
P.O. Box 125
Doniphan, MO 63935-0125
Toll-free: (800) 939-7894
Phone: (573) 996-7894
Fax: (888) 812-5170
Website: http://www.genericmedicineprogram.com
“Generic Medicine Program is an easy and affordable way for people of all ages to get medicines they need.
Everyone qualifies and enrollment is free to families and individuals of all ages nationwide, whether you have
insurance or not. In some cases this program will be less expensive than your prescription drug co-pay.
Through this program, you can get more than 2,000 generic medications that treat a wide range of conditions
including diabetes, asthma, heart disease, and depression. Our program ensures low-cost, predictable pharmaceutical services for those taking maintenance drugs.”
Benefits: This program provides you generic medications, in 90-day increments, by mail-order pharmacy for
prices that range from under $5 to $42 per month. Check the website for lists of covered medications.
Eligibility: Not Applicable.
Application: Request an enrollment form online, by phone or from the Patient Advocate. Fax or mail the completed form along with an original prescription to the listed number or address. Your medications will arrive by
mail within 7 days.
MedSaveInc.com
4461 Winnetka Ave N
New Hope, MN 55428
Phone: (866) 856-9633
Email: [email protected]
Website: http://www.medsaveinc.com
“MedSave offers the best prices and provides our customers excellent service … with no limitations such as
age, income or monthly membership fees. By eliminating costly relationships with insurance companies and
stocking primarily lower-cost generics, we have the ability to minimize expenses, allowing us to give discounts
as high as 70% off what you may pay in your local pharmacy. In many cases, MedSave Discount Pharmacy
pricing may be lower than your current insurance co-pay.”
31
Benefits: This company provides you with a free consultation on lower costs for your medications. You may
mail-order medications by phone.
Eligibility: Not Applicable.
Application: No application is necessary, however, you must participate in the phone consultation before you
may order medications. A prescription from your doctor is necessary.
Prescription911 Inc.
1463 E.Republican St
Seattle, WA 98112
Toll-Free: (877) 324-8818
Phone: (206) 324-8818
Fax: (206) 325-1650
Email: [email protected] or [email protected]
Website: http://www.prescription911.com/index.html
“As a U.S. pharmacy based in Seattle, Washington, our focus is helping non-insured Americans obtain affordable prescriptions… legally! Over half of our prices are lower than internet pharmacies based in Canada. Plus,
we provide jobs in the U.S. and pay taxes to support our police, firefighters, teachers, and your social security.”
Benefits: This company allows you to shop their formulary online for better prices on your medications, and to
have them shipped directly to you.
Eligibility: Not Applicable
Application: No application is necessary, however, you must either call and order by phone or fill out an order
form, which you may print from the website and mail with your prescription.
RxBids
9050 West Warm Springs Rd.
Bldg. 12, Unit 2129
Las Vegas, NV 89148
Toll-free: (866) 604-7203
Email: [email protected]
Website: http://www.rxbids.com
“The objective of RxBids is to save your money by having multiple pharmacies bid down the price of your prescription.”
Benefits: This organization allows pharmacies to bid on your prescription. The lowest-bidding pharmacy will
provide your medications by mail.
32
Eligibility: Not Applicable.
Application: Register online or by phone and mail your original prescription(s) to the listed address. You will
be assigned an ID number and pharmacies will bid on your prescription.
Rx Outreach
Express Scripts Specialty Distribution Services, Inc.
PO Box 66536
Saint Louis, MO 63166-6536
Toll-free: (800) 769-3880
Email: [email protected]
Website: http://www.rxoutreach.com
“Rx Outreach is an easy and affordable way for people of all ages to get medicines they need. Through this
Patient Assistance Program, people who qualify financially can get more than 107 prescription medications
that treat a wide range of conditions including diabetes, asthma, heart disease, and depression. People may take
advantage of the program even if they receive medicines through another discount prescription drug program.
The program is available to individuals and families with incomes of up to 250 percent of the federal poverty
level. For a family of four, this figure is about $50,000 per year.”
Benefits: This company allows you to obtain a 90-day supply of generic medications for $20, plus other nominal processing, shipping and handling fees; all told you pay around $7 a month for your medications. They are
shipped directly to you.
Eligibility: You must have an income of less than 250% of the poverty level (see Appendix I).
Application: You may complete and submit an application online, print it out and mail it, or call to apply over
the phone.
Wellpartner, Inc.
P.O. Box 5909
Portland, OR 97228-5909
Toll Free: (877) WELL-RXS (935-5797)
Fax: (866) 624-5797
Email: [email protected]
Website: http://www.wellpartner.com
“Wellpartner is a next generation pharmacy focused on managing prescription costs while improving pharmacy
care for consumers with chronic health conditions.”
Benefits: This company offers medications at lower costs than most mail-order pharmacies, through its
Wellpartner PLUS program and provides price quotes over the phone. Medications may be shipped directly to
your home or to a nearby pharmacy for pick-up.
33
Eligibility: Not applicable.
Application: Sign up for an account online or over the phone. You may then mail in your prescriptions with an
order form, which you can download from the website.
Xubex® Pharmaceutical Services
P.O. Box 1244
Winter Park, FL 32790-1244
Toll Free: (866) 699-8239
Phone: (407) 478-2663
Fax: (407) 671-7960
Email: [email protected]
Website: http://www.xubex.com/
“Historically, generic medications have not been available through Patient Assistance Programs. Now Xubex®
offers assistance to qualified individuals for generic medications through its innovative program. A licensed
pharmacist in the United States fills all prescriptions with the same medications available from your local pharmacy. There is no cost to join and no monthly fees. All medications are shipped discreetly to your home, office
or trusted family member.”
Benefits: This company allows you to obtain a 90-day supply of generic medications for $20, plus other nominal processing, shipping and handling fees. They are shipped directly to you.
Eligibility: You must have an income of less than 250% of the poverty level (see Appendix I).
Application: You may complete and submit an application online, print it out and mail it, or call to apply over
the phone.
34
Non-Profit Programs
There are also programs offered by non-profit programs; they consist primarily of co-pay assistance
foundations.
Co-Pay Assistance
For those who don’t qualify for any of the above programs because of insurance or other forms for drug coverage, there are several organizations that provide co-pay assistance services for some drugs. Unfortunately,
though, most of them don’t offer assistance for psychiatric medications.
The Chronic Disease Fund
2503 Windgate Drive
Frisco, TX 75034
Toll-free: (877) 968-7233
Phone: (972) 712-0201
Email: [email protected]
Website: http://www.cdfund.org
“The Chronic Disease Fund, a non-profit organization founded in 2003. Its focus is to provide assistance to
those under-insured patients who are diagnosed with chronic or life altering diseases that require the use of
expensive, specialty therapeutics.”
Benefits: This organization provides financial assistance to help patients with certain conditions afford certain
of their medications, through their network of participating pharmacies or through reimbursement of costs. It
also provides online therapy management support.
Eligibility: You must:
• be diagnosed with one of their covered diseases (see website)
• meet certain unpublished financial, geographic and household criteria.
Application: You may apply over the phone, online, or by printed out the application from their website and
mailing it in with required documentation.
The HealthWell Foundation
P.O. Box 4133
Gaithersburg, MD 20878
Toll-free: (800) 675-8416
Website: http://www.healthwellfoundation.org
“The HealthWell Foundation, a 501(c)(3) non-profit organization established in 2003 to address the needs of
35
individuals who cannot afford their insurance copayments, premiums, coinsurance, or other out-of-pocket
health care costs.”
Benefits: This organization helps qualifying patients with certain diseases to afford their copayments, premiums, deductibles, and other selected out-of-pocket health care expenses.
Eligibility: You must:
• be diagnosed with one of their covered diseases (see website)
• meet certain unpublished financial, geographic and household criteria.
Application: You may apply directly online, or call to have an application sent to you, which you may return
by mail.
Patient Access Network Foundation
PO Box 221858
Charlotte NC 28222-1858
Phone: (866) 316-PANF (7263)
Email: [email protected]
Website: https://www.patientaccessnetwork.org/
“The Patient Access Network Foundation is a non-profit 501(c)(3) organization dedicated to supporting the
needs of patients that cannot access the treatments they need due to out-of-pocket health care costs.”
Benefits: This program provides financial support for out-of-pocket costs associated with a wide range of
drugs, to treat a number of conditions (see website).
Eligibility: You must:
• be a U.S. resident
• meet certain unpublished financial, medical and insurance criteria
Application: You may apply online or call the number to have a representative walk you through the process.
All applications must be verified by the patient and their doctor and must include and be supported by appropriate documentation of the condition.
The Patient Advocate Foundation
PAF Co-Pay Relief
700 Thimble Shoals Boulevard
Suite 201
Newport News, VA 23606
Toll Free: (866) 512-3861
Fax: (757) 952-0119
Email: [email protected]
Website: http://www.copays.org
36
“The Patient Advocate Foundation, a national non-profit organization that seeks to safeguard patients through
effective mediation assuring access to care, maintenance of employment and preservation of their financial stability. The Patient Advocate Foundation's Co-Pay Relief (CPR) Program provides direct co-payment assistance
for pharmaceutical products to insured Americans who financially and medically qualify. The Program offers
personal service to all patients through the use of CPR call counselors.”
Benefits: This organization helps qualifying patients with certain diseases to afford their copayments.
Eligibility: You must:
• be diagnosed with one of their covered diseases (see website)
• meet certain unpublished financial, geographic and household criteria.
Application: Call the phone number to speak with a counselor and begin the application proces
Patient Services Incorporated
P.O. Box 1602
Midlothian, VA 23113
Toll-free: 800-366-7741
Fax: 804-744-5407
Email: [email protected]
Website: http://www.uneedpsi.org
“Patient Services Incorporated, developed in 1989, is a non-profit charitable organization primarily dedicated
to subsidizing the high cost of health insurance premiums and pharmacy co-payments for persons with specific
chronic illnesses and rare disorders. PSI is committed to assisting persons with chronic medical illnesses in
accessing health insurance and pharmacy co-payment assistance. Families requiring assistance in maintaining
the high cost of their health insurance premiums or co-payments are offered assistance based upon the severity
of medical and financial need. PSI offers a ‘safety net’ for persons who have expensive chronic illnesses and
for those persons who ‘fall through the financial assistance cracks.’”
Benefits: This organization specializes in premium and co-pay assistance and waiver services.
Eligibility: You must:
• be diagnosed with one of their covered diseases (see website)
• meet certain medical and financial criteria.
Application: Call the phone number to request an application, which must be mailed.
Generics
If all else fails, there’s always good old-fashioned frugality. Simply by asking your doctor about generic alternatives to your medications, and then shopping around to find the lowest price on those generics, you can save
a significant amount of money; fortunately, there are resources for this also. There are no eligibility criteria or
application processes associated with any of the following.
37
AGRX Ohio
Website: http://www.agrx.ag.state.oh.us
Sponsored by the Office of the Ohio Attorney General, AGRX Ohio lists medications and costs by participating pharmacies. While there are only a limited number of featured medications and participating pharmacies,
the website promises to update the list quarterly.
Consumer Reports Best Buy Drugs
Website: http://www.crbestbuydrugs.org
“The mission of the Consumer Reports Best Buy Drugs project is to provide consumers and their doctors with
information to help guide prescription drug choices–based on effectiveness, a drug's track record, safety and price.
“The project aims to improve access to needed medicines for tens of millions of Americans—because they lack
insurance coverage for prescription drugs, because the prices of many medicines today are so high, and
because many consumers and physicians may not be aware of proven and affordable alternatives.”
Giant Eagle Pharmacy
6300 Biddulph Road
Brooklyn, OH 44144
Phone: (216) 739-4125
13820 Lorain Road
Cleveland, OH 44111
Phone: (216) 476-4731
4401 Mayfield Road
South Euclid, OH 44121
Phone: (216) 297-2001
Benefits: Giant Eagle is now offering 30-day generic medications for $4 each, regardless of income or insurance. You may call the pharmacy directly or search the internet to find out more information. To obtain the
medications, you must sign up for a free Giant Eagle Advantage Card.
Kmart Pharmacy
7700 Brookpark Rd.
Cleveland, OH 44109
Phone: (216) 485-9594
12501 Rockside Rd.
Garfield Heights, OH
Phone: (216) 662-6602
38
33752 Vine St.
Eastlake, OH
Phone: (440) 951-7567
Toll-free: (866) KMART-4U (562-7848)
Website: https://pharmacy.kmartcorp.com/index.jsp
Benefits: Kmart offers their 90-day generics program to anyone, regardless of income or insurance, through
which one may obtain a 90-day generic prescription for only $15. This program may be accessed at any Kmart
that has a pharmacy. Several of the closest locations are listed above. You may search the internet, contact the
pharmacy directly, or contact the Patient Advocate for a comprehensive formulary.
Target Pharmacy
6850 Ridge Rd.
Parma, OH 44129-5627
Phone: (440) 842-9170
20001 Center Ridge Rd.
Rocky River, OH 44116-3640
Phone: (440) 895-2608
14070 Cedar Rd.
University Heights, OH 44118-3216
Phone: (216) 416-0026
Benefits: Target is now offering 30-day generic medications for $4 each, regardless of income or insurance.
You may call the pharmacy directly or search the internet to find out more information.
Wal-Mart Pharmacy
10000 Brookpark Rd.
Brooklyn, OH 44130
Phone: (216) 741-7340
5638 Transportation Blvd.
Garfield Heights, OH 44125
Phone: (216) 663-2884
8303 West Ridgewood Dr.
Parma, OH 44129
Phone: (440) 884-5641
Benefits: Wal-Mart is now offering 30-day generic medications for $4 each, regardless of income or insurance. You may call the pharmacy directly or search the internet to find out more information.
39
III. Conclusion
The resources profiled in this guide were compiled through hours of research and hopefully give a representative sampling of those available in each category. However, given time, space and subject matter constraints,
as well as the ever-changing medication assistance program landscape, there are undoubtedly more to be found.
So we’re inviting you to collaborate with us in this effort. If you know of a program that helps people access
more affordable medications, or if you have a success story, share it with us and you may be featured in our
next edition. Thank you.
40
Appendix I
2006 HHS Poverty Guidelines
Persons in
100% of the
Family or Household Federal Poverty Level
1
2
3
4
5
6
7
8
For each additional
person, add
150% FPL
200% FPL
$14,700
$19,800
$24,900
$30,000
$35,100
$40,200
$45,300
$50,400
$5,100
$19,600
$26,400
$33,200
$40,000
$46,800
$53,600
$60,400
$67,200
$6,800
$ 9,800
$13,200
$16,600
$20,000
$23,400
$26,800
$30,200
$33,600
$ 3,400
Appendix II
Medication List
The medications on this list only represent a sampling of those on the market, but most psychiatric
medications are featured.
Medications in BOLD have at least one associated no-cost Patient Assistance Program
Celexa
citalopram hydrobromide
Antidepressant
Depression
Forest
though some may have an additional low-cost assistance program associated with them as well.
Haldol haloperidol Antipsychotic Schizophrenia Psychosis, Tourette's Ortho Johnson &
Johnson, Together Rx
Medications in ITALICS have at least one associated low-cost assistance program.
fluoxetine, Prozac, Sarafem, Antidepressant - Antiobsessional, Depression, Bulimia, OCD
Mallinckrodt, Par, Pharm. Assoc.RxOutreach, Xubex, Kmart, Wal-Mart
Medications with a check (3)in the samples column are available as drug company samples through
Recovery Resources.
Lithobid
(see "lithium carbonate")
Antimanic
Bipolar
Solvay 3
41
Anxiety
Anxiety
Anxiety
Anxiolytic Antipanic
Antidepressant
Antidepressant
Antialcoholic
Antipsychotic
Antiparkinson
Antidepressant
Anxiolytic
Anxiolytic Sedative
Stimulant
Antidepressant
Antihistamine
Xanax
Symmetrel
zolpidem tartrate
Elavil, Endep
Ascendin
Adderal
Clomipramine
disulfiram
Abilify
trihexyphenidyl
amoxapine
hydroxyzine hcl
lorazepam
Strattera
nortriptyline,
Pamelor
diphenhydramine
alprazolam
amantadine
Ambien
amitriptyline
amoxapine
amphetamine
Anafranil
Antabuse
aripiprazole
Artane
Ascendin
Atarax
Ativan
atomoxetine
Aventyl
Benadryl
Shire US
Depression
Antidepressant Antiobsessional
Allergic diseases
Depression
ADHD
Depression
Parkinson's
Disease
Schizophrenia
Alcoholism
ADHD
Narcolepsy
Parke-Davis
Lilly
Biovail
Pfizer
Odyssey
Anxiety, OCD Mallinckrodt
Mallinckrodt
Watson
Mylan
Depression
Depression
Sanofi-Synthelabo
Pharm. Assoc.
Panic Disorder Mylan, Roxane
Narcolepsy
Anxiety, Bipolar
Bristol-Myers
Squibb, Otsuka
INDICATIONS MANUFACTURER
(Other)
Insomnia
Parkinson's
Disease
Stimulant
Hypnotic
Antiparkinson
ADHD
Stimulant
amphetamine
Adderall
Depression
Antidepressant
doxepin, sinequan
Alcoholism
Schizophrenia
INDICATIONS
Adapin
Antipsychotic
TYPE
Antialcoholic
Aripiprazole
other names
acamprosate calcium Campral
Abilify
Medication
MEDICATIONS
Mallinckrodt
RxOutreach, Xubex,
Kmart, Wal-Mart
TogetherRx
RxOutreach, Xubex
Shire US
Bristol-Myers,
Squibb, TogetherRx
PAPs
3
42
samples
Antimanic
(see "lithium
carbonate")
Celexa
Anafranil
Klonopin, Rivotril
Tranxene
Clozaril
Cibalith-S
citalopram
hydrobromide
clomipramine
clonazepam
clorazepate
dipotassium
Clozapine
Clozaril
Cogentin
Schizophrenia
Antipsychotic
Antiparkinson Antihistamine
Clozapine
benztropine
mesylate
Parkinson's
Disease
Schizophrenia
Anxiety
Epilepsy
Depression
Depression
Antipsychotic
Anxiolytic
Antidepressant Antiobsessional
Anticonvulsant Antipanic
Antidepressant
Schizophrenia
Antipsychotic Tranquilizer
Largactil, Thorazine
chlorpromazine
Bipolar
Anxiety
Anxiolytic
Limbitrol
Anxiety
chlordiazepoxideamitriptyline
Anxiolytic
Depression
Epilepsy
Epilepsy
Alcoholism
Anxiety
Anxiety
Librax, Librium
Anticonvulsant Antimanic
carbamazepine, Epitol, Anticonvulsant Equetro, Tegregol
Antimanic
citalopram
Antidepressant
hydrobromide
Antialcoholic
Anxiolytic
Anxiolytic
Depression
Parkinson's
Disease
Opioid
Dependence
INDICATIONS
chlordiazepoxide
Celexa
Carbatrol
carbamazepine
acamprosate
calcium
Carbatrol, Epitol,
Equetro, Tegretol
Buspar
buspirone
Campral
buspirone
Buspar
Antidepressant
Opioid Antagonist
Suboxone, Subutex
Wellbutrin, Zyban
Antiparkinson Antihistamine
TYPE
Cogentin
other names
bupropion
benztropine
mesylate
buprenophinenaloxone
Medication
Mylan, Taro
Mylan, Watson
Forest
Shire US
Taro
Forest
Mylan, Watson
Bristol-Myers
Squibb
Mylan
Par
Allergic
Diseases
Alcohol
Withdrawal
Ovation
Novartis
Ivax, Mylan
Mylan, Taro,
Watson
Panic Disorder Mylan, Watson
Anxiety, OCD
Bipolar
Depression
Alcoholism,
Insomnia
Bipolar
Bipolar
Allergic
Diseases
INDICATIONS MANUFACTURER
(Other)
MEDICATIONS
Ovation
Novartis,
TogetherRx
Ivax, Mylan
RxOutreach, Xubex
RxOutreach, Xubex
RxOutreach, Xubex
Forest
Shire US
Xubex, Kmart,
Wal-Mart
Forest
RxOutreach, Xubex,
Kmart
RxOutreach, Xubex
RxOutreach, Xubex,
Kmart, Wal-Mart
PAPs
3
43
samples
duloxetine
flurazepam
naltrexone, Revia
Cymbalta
Dalmane
Depade
Diastat, T-Quil,
Benadryl
Antabuse
diazepam
diphenhydramine
disulfiram
Antidepressant
Antidepressant
Adapin, Sinequan
Cymbalta
doxepin
duloxetine
Detoxificant
Depression
Depression
Narcotic
Withdrawal
Epilepsy
Anticonvulsant Antimanic
methadone,
methadose
Alcoholism
Allergic Diseases
Anxiety
Anxiety
ADHD
Depression
ADHD
Depression
Anxiety,
Bipolar
Bipolar
Bipolar
Bipolar
Epilepsy
Depression
Bipolar
Mylan, Par, Watson Xubex, Kmart,
Wal-Mart
Roxane
Ability
RxOutreach,
XubexWatson
Mylan, Roxane,
Watson
Pharm. Assoc.
Valeant
Xubex
Abbott,
TogetherRx
Abbott
Lilly
Johnson & Johnson,
Together Rx
PAPs
Xcel
Apothecon
Ovation
Watson
Merck
Abbott
Abbott
Mallinckrodt
Valeant
Lilly
Abbott
McNeil
INDICATIONS MANUFACTURER
(Other)
Epilepsy
Opioid Dependence
Antialcoholic
Antihistamine
Anxiolytic Sedative
Anxiolytic Sedative
Dolophine
divalproex sodium Depakote, Epival
diazepam, T-Quil,
Valium
Diastat
Stimulant
Antidepressant
trazodone
Desyrel
dexmethylphenidate Focalin
Stimulant
methamphetamine
Desoxyn
desipramine
Deplin
Depakote
Opioid Antagonist
Insomnia
Depression
Antidepressant
Hypnotic
ADHD
ADHD
INDICATIONS
Stimulant
valproic acid,
Anticonvulsant
valproate, Valrelease
divalproex sodium, Anticonvulsant Epival
Antimanic
Antipressant
l-methylfolate
Supplement
Norpramin,
Antidepressant
Pertofrane
pemoline
Depakene
TYPE
Metadate, Methylin,
Stimulant
methylphenidate, Ritalin
other names
Cylert
Concerta
Medication
MEDICATIONS
3
3
3
44
samples
amitriptyline, Endep
Elavil
Bipolar
Anxiolytic Antipsychotic
Antidepressant Antiobsessional
Prosom
Lunesta
perphenazine,
Trilafon
Prozac, Sarafem
Modecate, Permitil,
Prolixin
Dalmane
Luvox
Dexmethylphenidate Stimulant
Antimanic
(see "lithium
carbonate")
Eskalith
estrazolam
eszopiclone
Etrafon
fluoxetine
fluphenazine
flurazepam
fluvoxamine
Focalin
Neurontin
Hypnotic
Lexapro
escitalopram
oxalate
gabapentin
ADHD
Hypnotic
carbamazepine,Carbatrol,
Epival, Tegretol
Equetro
Insomnia
Depression
Antidepressant Antiobsessional
Schizophrenia
Depression
Psychosis
Insomnia
Insomnia
Bipolar
Depression
Neuralgia
Epilepsy
Hypnotic
Antipsychotic
Antimanic
divalproex sodium,
Depakote
Epival
Neuralgia
Anticonvulsant Antimanic
Anticonvulsant Antimanic
Anticonvulsant Antimanic
Antidepressant Anxiolytic
carbamazepine, Carbatrol,
Equetro, Tegretol
Epitol
Depression
Antidepressant
amitriptyline, Elavil
Parkinson's
Disease
Parkinson's
Disease
Endep
Emsam
Emsam, selegiline
Depression
Depression
Antidepressant Anxiolytic
Antidepressant
Bipolar
INDICATIONS
Antimanic
TYPE
Antiparkinsonian Antidepressant
Antiparkinsonian
Eldepryl, selegiline
Antidepressant
venlafaxine
Effexor
Eldepryl
(see "lithium
carbonate")
other names
Duralith
Medication
Watson
GlaxoSmithKline
Shire US
Bristol-Myers
Squibb
Mylan, Watson
Shire US
Bristol-Myers
Squibb
Wyeth
PAPs
OCD
Novartis
Mylan
Mylan
RxOutreach
Novartis,
TogetherRx
Xubex
RxOutreach, Xubex,
Bulimia, OCD Mallinckrodt,
Par, Pharm. Assoc. Kmart, Wal-Mart
Mylan, Par, Pharm. Xubex, Wal-Mart
Assoc.
Sleep apnea
Anxiety
Bipolar
Bipolar
Bipolar
Depression
Depression
Anxiety (Gen., Wyeth
Soc.)
INDICATIONS MANUFACTURER
(Other)
MEDICATIONS
3
3
45
samples
Depression
Epilepsy
Epilepsy
Cardiovascular
Agent
Antidepressant
Anticonvulsant Antipanic
Antiepileptic
Antiepileptic
Antipsychotic Tranquilizer
Janimine, Tofranil
propranolol
imipramine, Tofranil
clonazepam, Rivotril
lamotrigine
Lamictal
chlorpromazine,
Thorazine
Synthroid
imipramine
Inderal
Janimine
Klonopin
Lamictal
lamotrigine
Largactil
levothyroxine
Lithium Carbonate
Lithane
Limbitrol
Librium
Librax
Cibalith-S, Duralith, Eskalith,
Lithane, Lithobid, Lithonate,
Lithotabs
escitalopram
oxalate
chlordiazepoxide,
Librium
chlordiazepoxide,
Librax
cchlordiazepoxideAmitriptyline
(see "lithium
carbonate")
Hypertension
Antidepressant
Vistaril
hydroxyzine
pamoate
Lexapro
Depression
Anxiolytic
Atarax
hydroxyzine hcl
Schizophrenia
Epilepsy
Anxiety
Anxiety
Antimanic
Antimanic
Anxiolytic
Anxiolytic
Anxiolytic
Antidepressant
Bipolar
Bipolar
Anxiety
Anxiety
Anxiety
Depression
Hormone - Thyroid Hypothyroidism
Anxiolytic
Antipsychotic
Haldol
haloperidol
Schizophrenia
Schizophrenia
Antipsychotic
haloperidol
Haldol
Schizophrenia
INDICATIONS
Insomnia
triazolam
Halcion
Antipsychotic
TYPE
Hypnotic
ziprasidone
other names
Geodon
Medication
Wyeth
Depression
Alcoholism,
Insomnia
Alcoholism,
Insomnia
Bipolar
Roxane
Valeant
Valeant
Forest
Mylan
GlaxoSmithKline
Panic Disorder Roche
Anxiety
Par
Watson
RxOutreach, Xubex,
Kmart, Wal-Mart
Forest
Rx Outreach,
Xubex, Wal-Mart
Bridges to Access,
TogetherRx
Wyeth
Xubex, Kmart
RxOutreach,
Wal-Mart
Mylan, Ortho,
Pharm. Assoc.
Psychosis,
Tourette's
Watson
Johnson & Johnson,
Together Rx
Ortho
Pfizer, TogetherRx
PAPs
Psychosis,
Tourette's
Pharmacia
Pfizer
INDICATIONS MANUFACTURER
(Other)
MEDICATIONS
3
3
3
46
samples
ADHD
Narcotic
Withdrawal
Narcotic
Withdrawal
Antipsychotic
Antipsychotic
Hypnotic
Ativan
Loxitane
loxapine
eszopiclone
fluvoxamine
thioridazine
Namenda
Serentil
Concerta, Methylin,
Stimulant
methylphenidate, Ritalin
Dolophine,
Methadose
Dolophine,
methadone
lorazepam
lloxapine
Loxitane
Lunesta
Luvox
Mellaril
memantine
mesoridazine
besylate
Metadate
Remeron
Provigil
mirtazapine
modafinil
Stimulant
Narcolepsy
Depression
ADHD
Concerta, Metadate, Stimulant
Methylin, Ritalin
methylphenidate
Antidepressant
ADHD
Concerta, Metadate,
Stimulant
methyphenidate, Ritalin
Methylin
methamphetamine Desoxyn
ADHD
Detoxificant
Detoxificant
Schizophrenia
Alzheimer's
Disease
Schizophrenia
Depression
Insomnia
Schizophrenia
Schizophrenia
Anxiety
Depression
Stimulant
Methadose
methadone
Antipsychotic
Antialzheimer's
Antidepressant Antiobsessional
Antipsychotic Tranquilizer
Antipressant
Supplement
Anxiolytic Sedative
Bipolar
Bipolar
Deplin
Antimanic
Antimanic
Bipolar
INDICATIONS
l-Methylfolate
Lithotabs
Lithobid
Antimanic
TYPE
Lithonate
other names
(see "lithium
carbonate")
(see "lithium
carbonate")
(see "lithium
carbonate")
Medication
Narcolepsy
Anxiety,
Depression
OCD
Sleep apnea
Mylan, Par,
Roxane, Watson
Watson
Mallinckrodt
Mallinckrodt
Roxane
Celltech
Forest
Novartis
Sepracor
Watson
Watson
Mylan, Roxane,
Watson
Solvay
INDICATIONS MANUFACTURER
(Other)
MEDICATIONS
RxOutreach
RxOutreach, Xubex
PAPs
3
47
samples
Antidepressant
Antipsychotic Antimanic
gabapentin
desipramine,
Pertofrane
Aventyl, Pamelor
Zyprexa
Symbyax
pimozide
Serax
Trileptal
Neurontin
Norpramin
nortriptyline
olanzapine
olanzapinefluoxetine
Orap
oxazepam
oxcarbazepine
Paxil, Pexeva
paroxetine
Cylert
paroxetine
Paxil
pemoline
Parnate
Aventyl,
nortriptyline
tranylcypromine
sulfate
Schizophrenia
Antidepressant
Serzone
nefazodone hcl
Pamelor
Depression
Antimanic
Thiothixene
Schizophrenia
Bipolar
Depression
Bipolar
Depression
Schizophrenia
Stimulant
ADHD
Depression
Depression
Depression
Antidepressant
Antidepressant Anxiolytic
Antidepressant Anxiolytic
Depression
Bipolar
Antidepressant
Antimanic
Anxiolytic - Sedative Anxiety
Antipsychotic
Antipsychotic
Antidepressant
Antipsychotic
Depression
Navane
Antidepressant
Par
GlaxoSmithKline
Anxiety (Gen., Soc.),
OCD, Panic, PTSD
Anxiety (Gen., Soc.),
OCD, Panic, PTSD
Mallinckrodt
GlaxoSmithKline
Mallinckrodt
Gate
Mylan, Pharm.
Assoc., Watson
Parke-Davis
(Pfizer)
Mylan, Par, Watson
Pfizer
Bipolar
Alcohol
Withdrawal
Tourette's
Bipolar
Bipolar
Psychosis
Anxiety, Phobia, Parke-Davis
Hypochondria (Pfizer)
Forest
Alzheimer's
Disease
phenelzine sulfate
Mallinckrodt
Watson
INDICATIONS MANUFACTURER
(Other)
Opioid Dependence Alcoholism
Schizophrenia
INDICATIONS
Nardil
Antialzheimer's
Opioid Antagonist
Opioid Dependence
Opioid Antagonist
TYPE
memantine
fluphenazine,
Permitil, Prolixin
pentazocine,
Suboxone
Depade, Revia,
Vivitrol
other names
Namenda
naltrexone
naloxone
Modecate
Medication
MEDICATIONS
Bridges to Access,
TogetherRx
RxOutreach
Bridges to Access,
TogetherRx
Mallinckrodt
Gate
RxOutreach, Xubex,
Kmart, Wal-Mart
Aventis
Pfizer, TogetherRx
Pfizer, TogetherRx
Pfizer, TogetherRx
Forest
PAPs
3
3
48
samples
GlaxoSmithKline
Mallinckrodt
Hypertension
Antipsychotic
Antipsychotic
Cardiovascular
Agent
Hypnotic
Orap
fluphenazine,
Modecate, Permitil
inderal
estrazolam
Triptil, Vivactil
modafinil
Antidepressant fluoxetine, Sarafem Antiobsessional
Seroquel
Rozerem
mirtazapine
ropinirole
temazepam
naltrexone, Depade
risperidone
Pimozide
Prolixin
Propranolol
Prosom
protriptyline
Provigil
Prozac
quetiapine
ramelton
Remeron
Requip
Restoril
Revia
Risperdal
Antipsychotic
Opioid Antagonist
Hypnotic
Antidepressant
Hypnotic
Antipsychotic
Stimulant
Antidepressant
Schizophrenia
Antidepressant
Nardil
phenelzine sulfate
Schizophrenia
Opioid Dependence
Insomnia
Depression
Insomnia
Schizophrenia
Depression
Narcolepsy
Depression
Insomnia
Schizophrenia
Depression
Depression
Antidepressant Anxiolytic
Paroxetine
Pexeva
Cephalon
Abbott
Mylan, Watson
Apothecon
JDS
Schizophrenia Schizophrenia
Bristol-Myers
Squibb
Organon
Bulimia, OCD, Lilly
PMDD
Anxiety
Tourette's
Anxiety, Phobia,
Hypochondria
Anxiety (Gen., Soc.),
OCD, Panic, PTSD
Depression
Antidepressant
desipramine,
Norpramin
Pertofrane
Bipolar
Psychosis
Anxiolytic Antipsychotic
Etrafon, Trilafon
perphenazine
Mylan, Pharm.
Assoc.
Schizophrenia
Antipsychotic
fluphenazine,
Modecate, Prolixin
Watson
INDICATIONS MANUFACTURER
(Other)
Permitil
INDICATIONS
Opioid Dependence
TYPE
naloxone, Suboxone Opioid Antagonist
other names
pentazocine
Medication
MEDICATIONS
Johnson & Johnson,
Together Rx
Mallinckrodt
Bridges to Access,
TogetherRx
Lilly
NORD
RxOutreach, Xubex,
Wal-Mart
Equetro
PAPs
3
3
3
3
49
samples
Antipsychotic
ramelteon
fluoxetine, Prozac
Eldepryl, Emsam
oxazepam
mesoridazine
besylate
quetiapine
Zoloft
nefazodone hcl
Adapin, doxepin
zaleplon
trifluoperazine hcl
atomoxetine
Rozerem
Sarafem
selegiline
Serax
Serentil
Seroquel
sertraline
Serzone
Sinequan
Sonata
Stelazine
Strattera
Symmetrel
Symbyax
Subutex
Suboxone
Anxiolytic -Sedative Anxiety
Requip
ropinirole
Schizophrenia
Schizophrenia
AstraZeneca
Boehringer
Mylan, Watson
Antiparkinson
Lilly
Endo
Parkinson's
Disease
Reckitt
Opioid Dependence
Bipolar
Reckitt
Lilly
Opioid
Dependence
ADHD
GlaxoSmithKline
Psychosis,
Schizophrenia
Antipsychotic Anxiolytic
Stimulant
King
OCD, Panic,
Teva
PTSD, PMDD
Bristol-Myers
Squibb
Anxiety,
Pfizer
Bipolar
Alcohol
Withdrawal
Depression
Insomnia
Depression
Antidepressant Anxiolytic
Takeda
Novartis
Bulimia, OCD, Warner
PMDD
Panic Disorder
Psychosis
INDICATIONS MANUFACTURER
(Other)
Hypnotic
Depression
Antidepressant
Antidepressant Depression
Anxiolytic - Antipanic
Antipsychotic
buprenophineOpioid Antagonist
naloxone, Subutex
buprenophineOpioid Antagonist
naloxone, Suboxone
olanzapineAntipsychotic
fluoxetine
amantadine
Insomnia
Antidepressant Depression
Antiobsessional
Antiparkinsonian - Parkinson's
Disease
Antidepressant
Hypnotic
Parkinson's
Disease
Epilepsy
Anticonvulsant Antipanic
clonazepam,
Klonopin
Rivotril
Antiparkinsonian
ADHD
Stimulant
Concerta, Metadate,
Methylin, methylphenidate
Ritalin
Schizophrenia
INDICATIONS
Antipsychotic
TYPE
Risperdal
other names
risperidone
Medication
MEDICATIONS
Lilly
Reckitt
Lilly
Pfizer
RxOutreach
AstraZeneca,
TogetherRx
Kmart, Xubex
Takeda
Novartis,
TogetherRx
PAPs
3
3
3
50
samples
Schizophrenia
Antidepressant
Antipsychotic Tranquilizer
Antidepressant
Mellaril
Navane
Largactil,
chlorpromazine
imipramine,
Janimine
thioridazine
thiothixene
Parkinson's
Disease
Psychosis
Bipolar
Hypnotic
Antianxiety Antipsychotic
Antiparkinson
Anxiolytic Antipsychotic
Antimanic
Desyrel
Halcion
Stelazine
Artane
Etrafon,
perphenazine
oxcarbazepine
protriptyline, Vivactil
trazodone
triazolam
trifluoperazine
trihexyphenidyl
Trilafon
Trileptal
Triptil
valproate sodium
Diastat, diazepam,
T-Quil
Depakene, valproic
acid, Valrelease
Anxiety
Antidepressant
Parnate
tranylcypromine
sulfate
Valium
Insomnia
Antidepressant
clorazepate
dipotassium
Tranxene
Depression
Depression
Depression
Anxiety
Anticonvulsant
Epilepsy
Anxiolytic - Sedative Anxiety
Antidepressant
Anxiolytic
Anxiolytic - Sedative Anxiety
diazepam, Valium
T-Quil
Bipolar
topiramate
Antimanic
Schizophrenia
Antipsychotic Tranquilizer
Schizophrenia
Insomnia
Hypnotic
Topamax
Tofranil
Thorazine
Antipsychotic
Restoril
temazepam
Neuralgia
Anticonvulsant
carbamazepine,
Carbatrol, Epitol, Equetro
Tegretol
INDICATIONS
Hormore - Thyroid Hypothyroidis
TYPE
levothyroxine
other names
Synthroid
Medication
Par, Roxane
Watson
Ovation
Ortho
Mallinckrodt
GlaxoSmithKline
Mylan
Mylan
Mylan
Novartis
Bipolar
Roche
Novartis
Schering
Psychosis,
Mylan
Schizophrenia
Pharm. Assoc.,
Watson
Bipolar
Alcohol
Withdrawal
Bipolar
Psychosis
Anxiety,
Depression
Bipolar
Abbott
INDICATIONS MANUFACTURER
(Other)
MEDICATIONS
Novartis,
TogetherRx
Xubex
RxOutreach, Xubex,
Kmart, Wal-Mart
Johnson & Johnson,
Together Rx
Mallinckrodt
Wal-Mart
Wal-Mart
RxOutreach, Xubex
Novartis,
TogetherRx
Abbott
PAPs
3
51
samples
TYPE
Anxiety
Schizophrenia
Hypnotic
Antipsychotic
Antidepressant Anxiolytic - Antipanic Depression
Depression
Anxiolytic Antipanic
Hypnotic
Antidepressant
Antipsychotic Antimanic
alprazolam
Sonata
Geodon
sertraline hcl
Ambien
bupropion,
Wellbutrin
olanzapine
Xanax
zaleplon
ziprasidone
Zoloft
zolpidem tartrate
Zyban
Zyprexa
Insomnia
Schizophrenia
Insomnia
Depression
Antidepressant
bupropion, Zyban
Wellbutrin
Depade, naltrexone,
Opioid Antagonist Opioid
Revia
Dependence
Depression
Vivitrol
Antidepressant
GlaxoSmithKline
Cephalon
Odyssey
Bipolar
OCD, Panic,
PTSD, PMDD
Lilly
GlaxoSmithKline
Pfizer
Panic Disorder Pharmacia
Alcoholism
Anxiety (Gen., Mylan
Soc.)
Depression
Pfizer
Bipolar
Epilepsy
Anxiety
Bipolar
Pharm. Assoc.,
Watson
INDICATIONS MANUFACTURER
(Other)
Epilepsy
INDICATIONS
protriptyline, Triptil
Depakene, Valproate, Anticonvulsant
Valrelease
Depakene, Valproate,
Anticonvulsant
valproic acid
Antidepressant Effexor
Anxiolytic
hydroxyzine
Anxiolytic
pamoate
other names
Vivactil
Vistaril
venlafaxine
Valrelease
valproic acid
Medication
MEDICATIONS
Lilly
Bridges to Access,
TogetherRx
Pfizer, TogetherRx
Bridges to Access,
TogetherRx
Cephalon
Pfizer, TogetherRx
PAPs
3
3
52
samples
(866) 728-4368
(800) 736-0003
(800) 736-0003
(800) 459-7599
(800) 848-4876
Bristol-Myers
Squibb
Bristol-Myers
Squibb Abilify
Cephalon
Cephalon
(800) 424-3727
AstraZeneca
Foundation
Bridges To
Access
Depakene,
Depakote
(800) 222-6885
Abbott
Vivitrol
Provigil
Abilify
Emsam
Dexedrine
Lamictal, Parnate,
Paxil, Requip,
Wellbutrin, Zyban
Seroquel
medications
PHone
PAP
Income Criteria
Not Published
Income: <200%
FPL
Income Criteria
Not Published
Income Criteria
Not Published
US Resident,
Income:
<200% FPL
Income <300%
FPL: (1
- <$29,400; 2 <$39,600; 4 <$60,000)
FPL Guidelines
criteria
income
1040, W2, pay
stub,
SSA statement
All Medicare
beneficiaries
may qualify
benefit/
insurance
Medicare card,
SSA, LIS
or Medicaid
denial letter,
QMB / SLMB
statement
Eligible for
Medicare
D LIS, other
drug coverage
As Requested
No Medicare
beneficiaries
may qualify
No Medicare
beneficiaries
may qualify
Medicare
beneficiaries
without a part D
plan may qualify
Eligible for drug
coverage
Eligible for drug
coverage
Not Specified
None Required
As Requested
1040, W2 or pay
stubs
1040, pay
stub,
income
verification
sheet
None Required
Termination of
benefits
1040, 1099 forms Medicaid denial
letter
Medicare
Eligible for drug 1040, 1099 forms
coverage
beneficiaries
without a part D
plan may qualify
Medicare
beneficiaries
without a part D
plan may qualify
Eligible for drug 1040, W2, SSA, None Required
Medicare
coverage
through pension, railroad
beneficiaries
retirement,
without a part D State programs
Interest/Dividends
or private
plan may qualify
statements
insurance.
Eligible for
Medicare
part D w/ LIS
exclusions documentation documentation
medicare
Part d
Patient Assistance Programs
Appendix III
No Cost
No Cost
No Cost
No Cost
No Cost
No Cost
No Cost
cost
Physician office
Voucher
Physician office
Physician office
Physician office
Physician
office, home
address
Physician office
Physician office
access
53
Campral,
Lexapro,
Namenda
(800) 851-0758
(800) 292-4283
(800) 507-8334
(800) 652-6227
(800) 545-6962
(800) 259-7765
(888) 823-7823
(800) 277-2254
Forest
Pharmaceuticals
Gate
Pharmaceuticals
IVAX
Pharmaceuticals
Johnson &
Johnson
Lilly Cares
Mallinckrodt
Mylan
Novartis Clozaril
Clozaril
Clozapine
Anafranil,
Pamelor,
Restoril,
Tofranil
Cymbalta,
Prozac,
Strattera,
Symbyax,
Zyprexa
Concerta,
Haldol,
Risperdal,
Topamax
Clozapine
Orap
medications
PHone
PAP
All Medicare
beneficiaries
may qualify
Income Criteria
Not Published
US Resident,
Income
<300% FPL
All Medicare
beneficiaries
may qualify
Income: (1 No Medicare
<$13,110; 2 beneficiaries
<$16,875; 4 may qualify
<$25,725)
USResident, PAS
registration
No Medicare
beneficiaries
may qualify
All Medicare
beneficiaries
may qualify
No Medicare
beneficiaries
may qualify
No Medicare
beneficiaries
may qualify
Medicare
beneficiaries
without a part D
plan may qualify
medicare
Part d
Income Criteria
Not Published
Income <200%
FPL
Income Criteria
Not Published
US Citizen;
Income: (1 <$18,000; 2 <$24,000; 4 <$35,000)
ncome Criteria
Not Published
criteria
Eligible for
Medicare part D
w/ full-LIS
Not Specified
Not Specified
Eligible for drug
coverage
Eligible for
Medicare
part D
w/ full-LIS
Not Specified
Eligible for drug
coverage
that pays for
brand name
drugs
Not Specified
1040, W2, SSA
statement
1040, pay stub,
SSA statement
None Required
None Required
1040
None Required
None Required
None Required
income
benefit/
insurance
None Required
Pharmaceutical
coverage denial
None Required
None Required
None Required
None Required
None Required
None Required
exclusions documentation documentation
$5 / mo.
No Cost
40% Discount
No Cost
No Cost
No Cost
No Cost
No Cost
cost
Pharmacy card
Pharmacy
Pharmacy card
Physician office
Physician office
Pharmacy
Physician office
Physician office
access
54
Dilantin, Geodon
Nardil, Navane,
Neurontin, Vistaril,
Zarontin, Zoloft
Suboxone
Klonopin,
Valium
extensive list
of generic
medications
(800) 707-8990
(866) 906-2800
(866) 512-2216
(877) 757-6243
(800) 769-3880
Pfizer Connection
to Care
Pfizer Pfriends
Reckitt Benckiser
Roche
Pharmaceuticals
Rx Outreach
Dilantin, Geodon,
Nardil, Navane,
Neurontin,
Sinequan, Vistaril,
Zarontin, Zoloft
Cogentin
(866) 209-7604
Income:
(1 - <$24,500;
2 - <$33,000;
3 - <$41,500;
4 - <$50,000 +
$8,500 for each
additional person)
Eligible for drug
coverage
Eligible for drug
coverage
Eligible for drug
coverage
Have Insurance
Eligible for
Medicare
part D w/ full-LIS
Eligible for
Medicare part D
w/ full-LIS
Not Specified
Not Specified
None Required
1040
1040
None Required
1040, W2, 1099
forms
None Required
1040, pay stub,
SSA 1099,
Income
verification letter
1040, pay stub,
SSA 1099,
Income verification letter
income
benefit/
insurance
None Required
Medicaid denial
letter
None Required
None Required
None Required
Medicaid denial
letter
None Required
None Required
exclusions documentation documentation
Medicare
Eligible for public
beneficiaries
assistance
without a part D
plan may qualify
Not Specified
16 y/o, Income:
(1 - <$19,000;
2 - $21,000;
3 - <$32,000)
Outpatient
All Medicare
beneficiaries
may qualify
All Medicare
beneficiaries
may qualify
Income:
(1 - <$19,000;
2+ - <$31,000)
US Resident,
18 y/o
Not Specified
All Medicare
beneficiaries
may qualify
All Medicare
beneficiaries
may qualify
medicare
Part d
Income Criteria
Not Published
US Resident,
Income:
<200% FPL
(800) 277-2254 Tegretol, Trileptal
Ovation
Pharmaceuticals
Novartis
Tegretol/Trileptal
US Resident,
Income:
<200% FPL
Focalin, Ritalin
(800) 277-2254
Novartis
Focalin/Ritalin
criteria
medications
PHone
PAP
$20 (Tier 1),
$30 (Tier 2)
No Cost
No Cos
50% Discount
No Cost
No Cost
No Cost
No Cost
cost
Any address
Physician office
Not Specified
Not Specified
Physician office
Any address
Physician office
Pharmacy card
access
55
Adderall
Diastat
Effexor
(866) 325-8224
(866) 325-8224
(866) 325-8224
800) 830-9159
(800) 511-2120
(866) 590-5885
(866) 699-8239
Shire US
Adderall XR
Shire US
Carbatrol
Shire US Equetro
Takeda
Pharmaceuticals
America, Inc.
Valeant
Pharmaceuticals
Wyeth
Pharmaceutical
Assistance
Foundation
Xubex
Pharmaceutical
Services
extensive
list of
generic
medications
Rozerem
Equetro
Carbatrol
medications
PHone
PAP
Medicare
Eligible for drug
coverage
beneficiaries
without a part D
plan may qualify
Income:
(1 - <$24,674;
2 - <$32,141;
3 - <$40,890;
4 - <$48,675)
US or Puerto
Rico resident,
Income Criteria
Not Published
Income Criteria
Not Published
Income Criteria
Not Published
Not Specified
All Medicare
beneficiaries
may qualify
Medicare
beneficiaries
without a part D
plan may qualify
Not Specified
Eligible for drug
coverage
Not Specified
Medicare
Eligible for drug
coverage
beneficiaries
without a part D
plan may qualify
None Required
None Required
None Required
1040
None Required
None Required
1040
income
benefit/
insurance
None Required
None Required
None Required
Medicaid denial
letter
None Required
None Required
None Required
exclusions documentation documentation
Medicare
Eligible for drug
beneficiaries
coverage
without a part D
plan may qualify
medicare
Part d
Medicare
Eligible for drug
US Resident,
coverage
unable to afford beneficiaries
prescription drugs without a part D
plan may qualify
Income Criteria
Not Published
Income:
(1 - <$19,600;
2 - <$26,400;
3 - <$33,200;
4 - <$40,000;
5 - <$46,800;
6 - $53,600)
criteria
$20 - 90-day
$40 - 180-day,
$80 - 360-day
No Cost
No Cost
No Cost
No Cost
No Cost
$5 Copay
cost
Any address
Any address
Physician office
Physician office
Physician office
Physician office
Pharmacy card
access
56
Recovery Resources’ Programs and Services
Intake and Assessment: (216) 431-4131
Service Sites: Chester, Ohio City, Metzenbaum, and Lakewood
(See site locations, addresses, and phone numbers on the back cover of this Resource Guide.)
Alcohol and Drug Services
1. Intensive Outpatient Program
2. Aftercare
3. Counseling
4. Prevention Services
5. Supportive Housing
6. Case Management
7. Parenting
8. Vocational Support
9. Anger Management
10. Dual Diagnosis
11. AssistNow Employee Assistance
Program
Mental Health Services
12. Case Management
13. Group Counseling
14. Individual Counseling
15. Psychiatric Services
16. Anger Management
17. Partial Hospitalization Program
Forensic/Court Services
18. Jail Liaison Program
19. Community Re-Entry Programs
20. AssistNow Employee Assistance
Program
Helpful Community Service
Phone Numbers
Alcohol/Drug Abuse Assistance (Recovery Resources) . . . . . . . . (216) 431-4131
Alcohol and Drug Addiction Services Board
of Cuyahoga County (ADASBCC) . . . . . . . . . . . . . . . . . . . . (216) 348-4830
Ambulance/EMS/Fire/Police . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 911
Cuyahoga County Community Mental Health
Board (CCCMHB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (216) 241-3400
Cuyahoga County Department of Children and
Family Services (DCFS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (216) 696-5437
Cuyahoga County Public Library Toll Free Line . . . . . . . . . . . . . . (800) 749-5560
Human Service/Social Service Information:
First Call for Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Metro Health Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(216) 778-7878
Ohio Department of Jobs and Family Services/Medicaid
(ODJFS/Medicaid). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (800) 324-8680
Poison Control Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (800) 222-1222
RTA/Public Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (216) 621-9500
United Way of Greater Cleveland . . . . . . . . . . . . . . . . . . . . . . . . . . (216) 436-2000
Primary Site Locations
Headquarters:
3950 Chester Avenue
Cleveland, OH 44114
(216) 431-4131
Lakewood:
Ohio City:
Metzenbaum:
14805 Detroit Avenue
2900 Detroit Avenue
3343 Community College Avenue
Lakewood, OH 44107
Cleveland, OH 44113
Cleveland, OH 44115
(216) 226-2844
(216) 781-9222
(216) 241-5557
For more information please visit:
www.recovery-resources.org
Recovery Resources is certified by the Council on the Accreditation
of Rehabilitation Facilities (CARF)
Affiliate Agency of: