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Nonprofit foundation helps find prescription medication assistance
October 4, 2012 @ 9:30am | Rodika Tollefson
Pharmaceutical companies have long made prescription medications available to individuals who meet certain income criteria, especially to those who are ininsured and underinsured. Several websites now help consumers find these programs based on the medications they need, but one of the challenges is navigating through the qualification process — different for each company — and completing the required paperwork.
“There’s a tremendous amount of assistance for people who can’t afford prescription medicines. The challenge is that people don’t know about the assistance, and accessing it can be difficult,” said Todd Myers, executive director for the Prescription Drug Assistance Foundation.
The statewide foundation (www.mtgmeds.org/pdaf.html), based in Seattle, was created by the state Legislature several years ago to help fill that gap, and has launched several pilot projects across the state since then. One of them is in Mason County, where prescription assistance coordinator Annette Brown helps people tap into programs offered by pharmaceutical companies as well as other organizations. Her services are free, funded through the foundation.
“It’s a very individualized process. I have to look at each medication and what’s available,” she said. “If there are programs available, I will help them fill out the paperwork and get it submitted. My role is helping people access the programs that are there. A lot of folks don’t know about them or don’t understand the process so they have barriers, and my role is to help the process be easy and smooth.”
The programs are usually available for uninsured, low-income individuals (typically living at or below 200 percent of the federal poverty level) but some programs have higher income qualifications, as high as 400 percent. The programs can be accessed by anyone doing a little online research (there are also centralized websites like benefitscheckup.org), but Brown helps ensure all the steps are followed properly.
In general, these types of programs qualify people for a year, and they will either mail medicines to the physicians’ offices or the patients’ home.
Myers said $6.5 million in medication assistance was provided through the foundation last year, or about 10 percent of the state’s prescription budget. The foundation’s funding comes from private contributions, fundraising and some grants; it does not receive money through the state’s general budget.
In Puget Sound, Brown is currently one of only two coordinators — the other is in the Seattle area — but Myers said anyone else from local areas can call the foundation’s number (888-779-2527) and get assistance through them. His hope is to find more partners in different communities so more coordinators can be added, as funding allows.
“We reach out to community organizations like hospitals and clinics or others interested in delivering medications, and working with them on funding and logistical support,” he said. “We’re only successful if we have partnerships with people in the community who are already providing services.”
Other resources on the Kitsap Peninsula for those who need medication help include Peninsula Community Health Services, Kitsap County Aging and Long Term Care and South Sound Outreach.
Peninsula Community Health Services (www.pchsweb.org) has several options for its patients. In addition to access to less expensive medication, drugs from Pfizer and AstraZeneca can be dispensed in-house for those who qualify under the two companies’ guidelines for free medications. For other medicines, PCHS will fill out paperwork and apply on behalf of patients, and the medications are shipped to the clinic.
The Kitsap County Division of Aging & Long Term Care (www.kitsapgov.com/altc) works with seniors and is the local sponsor for the Kitsap County Statewide Health Insurance Benefits Advisors (SHIBA) program. SHIBA volunteers help seniors navigate Medicare plan options including Part D, which covers prescriptions. In addition to SHIBA, the agency’s senior information and assistance program can provide information and resources on prescription help, including reviewing results of the Benefits Checkup website and helping apply to programs. Staff will also send questionnaires to those who don’t have online access and run the reports on behalf of those seniors.
South Sound Outreach (www.southsoundoutreach.org), based in Tacoma, works with clients in the Gig Harbor area and as far as Kitsap. The nonprofit offers assistance to clients without prescription coverage in accessing free or reduced-cost medications. The services include sending the applications in and tracking clients’ approval expiration dates so they can reapply for eligibility review. Individuals who need this kind of assistance don’t have to be current clients to come in. The agency also sends representatives every week to the Key Peninsula Lutheran Church in Lakebay.
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