How to Pay for Medications You Cannot Afford
Unfortunately, many Americans find themselves in
situations where they cannot afford medications. There
are many reasons for this such as: a) no insurance
coverage, b) termination of coverage through workers
compensation or no-fault insurance, c) excessively high
co-pays combined with a limited ability to pay due to
poverty, d) high cost of medications.
As a result, many patients assume that there is no way to get the medication they need
when this is not necessarily the case. What follows is a list of resources that you, a
loved one, or friend can use to obtain the medications you need when limited finances
1. CONTACT THE PHARMACEUTICAL COMPANY THAT MAKES YOUR
Did you know that many pharmaceutical companies have special programs for those
who cannot afford it? Generally, a three-month medication supply is provided. After this
time period, a new request is needed just as a new prescription is needed when refills
are exhausted. Medications are shipped directly to the patient or physician in about two
weeks, but some programs request up to a six-week lead time. The following resources
can help you find medication assistance programs:
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 medications they need
through the public or private program that is 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 180 programs offered by pharmaceutical companies.
Patients can determine which programs they may be eligible for by answering questions and using the
online application wizard. To access the Partnership for Prescription Assistance by phone, you can call
toll-free at 1-888-4PPA-NOW (1-888-477-2669).
Needy Meds.org: A non-profit organization with the mission of helping people who cannot afford to pay
for their medications. Click the link to find patient assistant programs through their website.
2. CHECK IF YOUR STATE HAS A PHARMACEUTICAL ASSISTANCE PROGRAM
Many states have pharmaceutical assistance programs for qualifying residents. Qualifications vary, and
some programs are only for senior citizens. The National Conference of State Legislatures maintains a
state by state list of these programs with contact information. You can also try contacting your county
health department (check your telephone book) to see if there are other programs in your particular state
3. PURCHASE MORE AFFORDABLE HEALTH INSURANCE
For those who have excessive insurance premium costs, one option is to explore purchasing more
affordable health insurance. There are various insurances and health care plans available such as
HMOs (health maintenance organizations), PPOs (preferred provider organizations), POS (point of
service plans), indemnity plans (fee for service plans), and health savings accounts. Talking to a local
insurance agent can help you figure out which is the best option for you and which can help you best
afford your medications.
4. CONSIDER GENERIC INSTEAD OF BRAND NAME MEDICATIONS
After a certain period of time, pharmaceutical companies must allow other companies to produce their
medication. Generic medications must have the same active ingredients as the name brand, but the
inactive ingredients could be different. Inactive ingredients may include colors, preservatives, or other
fillers. A pharmaceutical company that wishes to sell their generic medication must prove to the Food
and Drug Administration (FDA) that it is equivalent (known as "bioequivalent") to the brand name
medication. To be bioequivalent, the active ingredients in a generic medication must be absorbed at a
similar rate and in a similar amount as the brand name medication. The generic does not have to act
exactly the same as the brand name medication, but it does have to fall within certain guidelines set by
the FDA. These guidelines may vary from medication to medication.
To be sure that the generic medication you are offered has been established as bioequivalent to the
brand name, always check with your pharmacist. Your pharmacist has access to information about
generic medications from the FDA's Orange Book. The Orange Book contains listings of medications
and their bioequivalency status. The electronic version of the Orange Book is searchable by active
ingredient and brand name.
If your doctor has written a prescription for a medication using the brand name for that medication, the
pharmacist must fill it with that specific medication. The pharmacist can call your doctor and talk about
substituting a generic form of the medication. Alternatively, you can talk with your doctor about generic
vs. prescription medications when the prescription is written.
Generic versions are not available for all brand name medications, but it is worth asking your doctor
about this since it can save you significant money. For more information on generic medication, see the
5. ASK FOR FREE SAMPLES
If there is no generic version of your medication available, ask if your health care provider has samples
of the medication. Many doctors are given free samples of commonly used medications by drug
company representatives. This is not a long-term solution, but a few samples might be able to hold you
over until a real solution is found.
6. LOOK INTO PILL SPLITTING
You may be able to save money by purchasing your medication in a double dose and splitting the pills.
Again, you will need to discuss this possibility with your health care provider. This approach cannot be
used with all medications.
7. ASK FOR LONGER PRESCRIPTION INTERVALS
Instead of getting a prescription filled that will only last 30 days, you can request one that will last for 60
to 90 days if you anticipate future financial hardship or termination of insurance benefits. Your health
care provider's willingness to do this will depend on the type of medication. For example, this request will
be more likely to be granted for an anti-depressant medication than a narcotic pain reliever, due to the
8. CONSIDER APPLYING FOR MEDICAID
Medicaid is a health insurance program funded at the federal (national) and state level for individuals and
families with low incomes and resources. The application process, eligibility requirements, and coverage
policies vary from state to state. In some states, people who qualify for Supplemental Security Income
(SSI) automatically qualify for Medicaid. It is best to contact the Medicaid agency in your state for an
application and any questions you may have, particularly about whether or not Medicaid covers
prescriptions in your state. Your local Department of Social Service (check your telephone book) may be
able to help you with the process. In New York state, the website for Medicaid is found here. In
Syracuse (Onondaga County), the contact information for Department of Social Services is Onondaga
County Civic Center, 421 Montgomery Street , Syracuse, New York 13202-2923 (phone: 315-435-
9. ORDER PRESCRIPTIONS ONLINE
It is possible to save money on your prescription drug costs by ordering them through an online
pharmacy. In many cases, these prescriptions will end up costing a fraction of what they do through your
local drug store, saving you a great deal of money in the process. All you have to do is fill out an online
order form and your prescription will be delivered right to your door. Not only does this method allow you
to save money by purchasing your medication online, but it also takes much of the hassle out of visiting
the pharmacy and waiting for your prescription to be filled.