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Prescription
Drug Programs
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Prescription
drugs can
now effectively treat a wide variety of illnesses
and diseases for which little help was available
only a few years ago. Unfortunately, methods of
paying for prescriptions have not kept pace. Whether
or not you have full insurance coverage, cost can
be a serious concern. Call the HelpLine at 1-800-965-7476
for more information or help with any of the programs
listed below.
What you'll
find on this page:
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DEL (Low Cost Drugs
for the Elderly or Disabled)
This is a discount program offered through the Department
of Health and Human Services (DHHS). Many people who
are either disabled or 62 and older who do not qualify
for MaineCare, can get this help. DEL provides an 80%
discount off the cost of many commonly used drugs. Some
people with high medication costs may be able to get
coverage of less commonly used drugs. For people who
already have Medicare, DEL does not take the place of
Part D (Medicare prescription coverage). But, it may
help to "wrap around" the Part D coverage
in some cases. If you are eligible, it is good to apply
for DEL.
What
about "Estate Recovery?"
Estate
Recovery does
NOT apply to this program. Estate Recovery is when
DHHS attempts to recover the cost of MaineCare services
from an enrollee's estate once they have passed away,
if they have no surviving spouse or dependants, and
if they had MaineCare when they were age 55 or over.
This can apply to some people enrolled in full coverage
MaineCare (another program offered through DHHS),
but NOT to people enrolled in DEL.
Asset
guidelines
Assets
do NOT count against you when applying for this program.
Income
guidelines
For
self-employed income, use your net income (after business
expenses and taxes). For all other income types, use
the gross amount (the amount before any taxes or expenses
are taken out). Even if your income is above the
levels listed you should apply anyway! If
you spend a lot of money on medication, you could
have higher income and still qualify. If you have
questions, or are unsure whether you qualify, call
our HelpLine at 1-800-965-7476.
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2009/2010*
Monthly Income Guidelines for
DEL (Low Cost Drugs
for the Elderly or Disabled)
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Family
Size
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Income
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1
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$1,670
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2
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$2,247
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3
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$2,823
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4
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$3,400
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5
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$3,976
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6
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$4,553
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For
each additional family member add:
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$577
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Note:
Some money can be "disregarded" or ignored
when applying. So even if you are a little over
income guidelines listed above, you should apply
anyway. If you are unsure, call our HelpLine at
1-800-965-7476.
*Income
Guidelines are based on Federal Poverty Guidelines,
which are calculated by a set formula every year.
For the first time in the history of the Federal
Poverty Guidelines, income limits for programs would
have gone down for 2010. To avoid people losing
coverage, the Obama Administration decided not to
change the Federal Poverty Guidelines at all this
year.
Maine
Rx Plus
This is a discount program offered through the Department
of Health and Human Services (DHHS). Many low and middle-income
people who do not qualify for MaineCare, can get this
help. Maine Rx Plus provides a 60% discount off the
cost of many commonly used generic drugs at many pharmacies
across Maine (only 15% off brand-name drugs). For people
who already have Medicare, Maine Rx Plus does not take
the place of Part D (Medicare prescription coverage).
But, it may help to "wrap around" the Part
D coverage in some cases. If you are eligible, it is
good to apply
for MaineRx Plus.
What
about "Estate Recovery?"
Estate
Recovery does NOT applying to this program. Estate
Recovery is when DHHS attempts to recover the cost
of MaineCare services from an enrollee's estate once
they have passed away, if they have no surviving spouse
or dependants, and if they had MaineCare when they
were age 55 or over. This can
apply to some people enrolled in full coverage MaineCare
(another program offered through DHHS), but not to
people enrolled in Maine Rx Plus.
Asset
guidelines
Assets
do NOT count against you when applying for this program.
Income
guidelines
For
self-employed income, use your net income (after business
expenses and taxes). For all other income types, use
the gross amount (the amount before any taxes or expenses
are taken out). Even if your income is above the
levels listed you should apply anyway! If
you spend a lot of money on medication, you could
have higher income and still qualify. If you have
questions, or are unsure whether you qualify, call
our HelpLine at 1-800-965-7476.
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2009
Monthly Income Guidelines for
Maine Rx Plus
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Family
Size
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Income
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1
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$3,159
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2
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$4,250
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3
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$5,341
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4
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$6,432
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5
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$7,523
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6
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$8,613
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For
each additional family member add:
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$1.091
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Note: Some money can be "disregarded" or
ignored when applying. So even if you are a little over
income guidelines listed above, you should apply anyway.
If you are unsure, call our HelpLine at 1-800-965-7476.
$4
Generics
Another
way to save on prescriptions is by switching to generic.
Generic medications are usually much cheaper than “brand
name” drugs and may make it easier to find discounts.
Many big retail store pharmacies have started providing
many generic medications for only $4, regardless of
your income or insurance status. Smaller, local pharmacies
sometimes have generous discount programs as well.
It’s a good idea to call the pharmacies nearest
to you and ask about any discount programs that they
offer!
Help with "Brand
Name" Drugs
State prescription assistance programs like Maine Rx
Plus can be helpful, but sometimes those programs don’t
help enough. Community-based Prescription Assistance
Programs (CPAPs) can search through their database
to find other programs to help with the cost of medications.
The CPAPs keep the latest information on a large number
of drug company discount cards and discount programs
for specific drugs. Staff can provide you with free
information and help you to apply for discounts. Click
here for more information.
Free Samples
Sometimes
Health
Center, Hospitals, and Free Clinics are
given free samples of certain medications that they
can share with their patients. This assistance is
usually not a long-term solution, but can definitely
help! Whenever you are prescribed a medication, it
never hurts to ask if there are free samples available.
Ordering
Drugs from Canada
For
information about mail-ordering drugs from Canada,
visit the Health
Canada Web site to learn how to protect
yourself from fraudulent companies, or call the Maine
Citizen Leadership Fund (207-780-8657).
Help with Private
Insurance Co-pays
Even if you have insurance coverage, cost may still
be an issue. Some people may be able to get help paying
their co-pays if they meet certain income and medical
guidelines. For more information visit the Patient
Advocate Foundation's Co-pay
Relief web
site. Call the HelpLine at 1-800-965-7476 for
more details.
TRICARE
Military retirees, and some family members or former
spouses age 65 and older may be eligible for two programs
provided by the Department of Defense: TRICARE for
Life and the TRICARE Senior Pharmacy Program. For
more information and complete eligibility requirements
for the TRICARE for Life and TRICARE Senior Pharmacy
Program, contact Sierra Military Health Services (the
Northeast Regional Contractor) toll free at 1-888-999-5195.
Medicare Part
D
If
you are eligible for Medicare, you can get prescription
coverage through "Part D" of the Medicare
program. Part D plans are offered through a variety
of private companies. It can be difficult to figure
out which company to go with because each plan covers
different drugs at different levels. Many people have
to pay a monthly premium for a Part D plan - But many
Maine people qualify for programs that pay this premium
for them. If you qualify for a MaineCare
Savings Program, many of your Medicare
costs will be paid for you. Part D is optional,
though if you do not sign up for it within a certain
time frame, or have other "creditable" coverage
in its place, you will have to pay a higher premium
rate for Part D in the future. For
help figuring out which Part D plan is best for you,
if you qualify for "extra help" with your
Part D costs, and for information about how the new
Part D will affect your state-based prescription coverage,
you can contact your local Area Agency on Aging at
1-877-353-3771 for assistance and referrals.
Veterans Benefits
CHAMPVA is a health care benefits program through
the Department
of Veterans Affairs (VA). For the spouse
or widow(er) and for the children of a veteran who:
is rated permanently and totally disabled due to a
service-connected disability; was rated permanently
and totally disabled due to a service-connected condition
at the time of death; died of a service-connected
disability; died on active duty and the dependents
are not otherwise eligible for DoD TRICARE benefits.
Under CHAMPVA, VA shares the cost of covered health
care services and supplies with eligible beneficiaries.
HIV/AIDS Assistance
If
you have been diagnosed with HIV/AIDS and you are
a resident of Maine, you could get assistance from
the State of Maine to get HIV-related medications
free of charge. The Aids Drug Assistance Program (ADAP)
is a program of the Maine Center for Disease Control
and Prevention (Maine CDC), HIV/STD Division. If
you are interested in ADAP contact the Maine CDC at
(207) 287-2899. You can also contact one of the HIV/AIDS
organizations in the state or contact the AIDS Hotline
at 1-800-851-2437.
Hospital Programs
Many
hospitals in Maine provide free or reduced-cost emergency
services to people at certain income levels. Some
hospitals go above and beyond just the emergency services
and will also provide help with medications and other
services. For more information, check out our page
on Hospital
Programs, or call the HelpLine at 1-800-965-7476.
