Prescription Assistance Programs

The type of coverage you have decides which programs you can use. Manufacturer copay cards often help people with commercial insurance, but federal rules generally prevent them from being used with Medicare, Medicaid or other government plans. People with Medicare may instead qualify for Extra Help with Part D costs or for grants from independent charitable foundations that cover copays for specific diagnoses. Manufacturer patient assistance programs may supply medicine at no cost to people with limited income or no insurance. Some cancer centers and specialty pharmacies also keep their own small assistance funds. Knowing your coverage type narrows the list quickly.

Oncology pharmacists, specialty pharmacy staff and hospital financial counselors handle assistance applications every day. They usually know which programs cover a particular drug, which foundation funds are open and what paperwork each one wants. Ask for their help as soon as a new medicine is prescribed, ideally before the first dose, because approval can take days or weeks. Expect to provide proof of income, your insurance details and a copy of the prescription. Some programs need your doctor's signature as well. Keep copies of everything submitted, and write down the program's phone number and your application or member number for later calls.

Assistance is rarely permanent. Many programs require renewal each year, and a change in insurance, income or medication can mean starting a new application. Charitable foundation funds for specific diagnoses open and close as donations come in, so a fund that is closed today may reopen later. Put renewal dates on your calendar and keep a folder of the documents programs usually request. If your treatment switches to a different drug, ask the pharmacy team right away whether your current help carries over. If a program runs out of money or denies you, ask whether there is a waiting list and what alternatives exist.

1. 1

   Ask your oncology pharmacist which assistance programs cover your specific medicine and insurance type.

2. 2

   Gather proof of income, insurance cards and prescription details before any application is started.

3. 3

   Request help before your first dose so approval does not delay treatment.

4. 4

   Set calendar reminders for annual renewals and after any change in insurance or medication.