Getting Assistance for the Donut Hole in Prescription Drugs

A big worry for people who are covered by part D prescription coverage is the dreaded donut hole--the part after initial coverage, that drops coverage, before the cost is covered again. Is there any assistance available for this cost? Sometimes, in some circumstances, there is.

By 2020, the Affordable Health Care Act will gradually erase the donut hole. Until then, some patient assistance programs set up by drugmakers to help uninsured and underinsured people will help with the donut hole. RxAssist has a page devoted to specific drug manufacturers and the drugs for which they will prove donut hole assistance.

The Patient Advocates Foundation also has a copay assistance fund for several potentially catastrophic illnesses. Check this list and see if you qualify, and apply online.

Ohio Prescription Discount Now for All Ohioans. And Other Ways to Get Prescription Drugs if You Aren't Insured

Ohio's Best Rx plan, a prescription discount plan once reserved for those 65 and over or the disabled, is not extended to everybody.  There are additional discounts for those making less than 300% of the poverty level.  This is NOT drug insurance, merely a discount, but if you are uninsured or underinsured, you can put in your zip code and the name of your medicine, and get a cost, and see if it's worth your while. 

For people with low to moderate incomes and no insurance, some pharmaceutical companies have their own programs that may make prescription drugs within reach.  Rx for Ohio works to make eligible Ohioans aware of programs for free or deeply discounted drugs, and give them the tools to make those contacts.  Just click on this page and start.  Input the name of your drug, answer 10 questions to determine your eligibility, and if you qualify for any program, they will link you to the applications that you can print out. 

If you're from anywhere else in the U.S., try the Partnership for Prescription Assistance.  It is a nationwide  program that makes people aware of prescription drug programs from manufacturers.  You can check out their webpage, or call 1-888-477-2669 for more information. 

Comparing Insurance Costs and Options--And Comparing Hospitals

Since I last wrote about the Healthcare.gov page in July, when it was brand new, features have been added that allow you to see different health care options for your situation.  One new feature is a comparison of the quality of health care facilities (hospitals, nursing homes, and home health care agencies) within a geographic area.  Just choose the type of facilities you want compared, put in your zip code, and it shows you various criteria on quality.

Another possibilityfor comparing health plans is the Health Sherpa. Www.thehealthsherpa.com This site, set up by some California techies, canhelp you find a plan when the federal site is down.
A feature has been added to find sources of health insurance and affordable health care.  Under "find insurance options," you can answer a few questions about your area, age, dependents (they don't ask for identification, just the basic info), and they lay out some options for you: private insurance for individuals, insurance through work, high risk pools, medicaid, or "finding care you can afford" (translation: public health care facilities,)  These include public clinics, HIV clinics, and Hill-Burton obligated facilities (hospitals that provide low-cost care for the indigent).  Under "health insurance plans for individuals and families," it will lay out all the options, plus some ways to narrow down your options (by deductible, by coverage options, by premium ranges, etc.)  They take great pains to note that the estimates are in fact only that, and that you may be charged more, but at least you have something to go on.

However, they left out the drug prescription component for the underinsured and noninsured.  Try this site and this site to cover your options on finding affordable drugs.

How to Get Drugs, When You Have No Insurance

Many drug companies have programs to aid people who need prescription medications and who are not covered by government programs or private insurance. Qualifications vary by company. For a complete list, see this website or call the toll-free number 1-888-4PPA-NOW. (or 1-888-477-2669) A listing for psychotropic drugs for the mentally ill is available at the NAMI website. Another source of information about prescription help from pharmaceutical companies is RX assist. Free registration required.