Help Paying for Rx
Get Help Paying for Prescriptions
Mainers who cannot afford their medications should know that many public and private programs are available to provide free or low-cost prescription medicines if you qualify.
Tell your insurance agent if you can’t afford your medicines.
Your agent can help you access these programs. As an agent I have a lot of experience helping people find Medicare and individual health insurance coverage for expensive drugs.
And because I deal with this issue almost every day, I know what programs may be best suited to help. Your insurance agent or broker that helps you review your coverage every year also should have a good idea how to help.
I put together the following list of resources that I use every day to help my clients. I hope you find it helpful. If you want my help or just want to ask a question fill out the form at the bottom of this page to send me an e-mail or call me anytime at 207-370-0143 and I will do mt best to help you!
Talk to your doctor
Your doctor’s office can help you apply to these programs themselves or refer you to one of Maine’s 15 hospital-based prescription assistance programs. Don’t put yourself at increased risk of getting sicker by skipping the medicines you need because it’s too expensive.
Whether or not you have a Medicare Supplement plan with a separate Part D prescription plan or an all-in-one type Medicare Advantage plan that includes prescription drug coverage, your cost for prescriptions can increase when you hit the donut hole.
Medicare Savings Programs (MSP, QMB, SLMB, QI)
If you have Medicare but need help with prescription drug costs, the MSP can be a huge help. Depending on what level you qualify for, you could get help paying for Part B and Part D premiums, copays, coinsurance, and deductibles. [READ MORE]
DEL PROGRAM (Low Cost Drugs for the Elderly or Disabled)
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. If you are over 65 and 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.
Maine Rx Plus
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). There may be other programs that can help pay more of your drug costs, but if not, it is good to apply for MaineRx Plus.
Community-based Prescription Assistance Programs (CPAPs).
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. For more information, see this flyer: Help with Prescriptions.
$4 Generics List Available at Most Pharmacies
Another way to save on prescriptions is by switching to generic. Generic medications can sometimes be less expensive than brand name drugs and may make it easier to find discounts.
Many pharmacies have started providing 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.
Each Pharmacy will have a list of drugs they offer at $4. If your drug is not on the list call around. Each pharmacy has a different list so if you don’t find your generic drug on one list it may be on another. [READ MORE ABOUT HOW THESE $4 COPAY LISTS WORK]
Sometimes Health Centers, 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.
Safely Ordering Drugs from Canada
For information about mail-ordering drugs from Canada, visit the Health Canada website to learn how to protect yourself from fraudulent companies.
Help with Private Insurance Co-pays
Even if you have health insurance through the Maine Health Insurance Marketplace, 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 website or call us toll free at 866-976-9038 for more details.
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 888-999-5195.
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.
VA and Medicare
As a Medicare-eligible Veteran, you have more options when it comes to healthcare and costs savings programs. To confirm your options call the Veterans Administration directly at 1-877-222-VETS (8387). [READ MORE ABOUT HO MEDICARE WORKS WITH VA BENEFITS]
If you have been diagnosed with HIV 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.
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. If you have questions about free care in Maine you can call the Maine Consumer Assistance Helpline at 1-800-965-7476.
MedAccess works with individuals and health care providers to identify ways patients can save money on prescription medications. The free program, administered by MaineHealth, helps patients and health care providers evaluate options such as pharmaceutical companies’ patient assistance programs, low-cost generic programs, and Medicare Part D and state and local prescription programs that can help save on prescription medication costs. For more information, see the MaineHealth MedAccess Program. MedAccess is part of the MaineHealth CarePartners Program.
Drug Safety, Effectiveness, and Cost
Consumer Reports Health Best Buy Drugs offers free, trusted educational resources to help you access the safest, most effective, and most affordable prescription drugs available. This resource is a grant-funded project providing independent, evidence-based reports on prescription drugs based on research conducted at the Drug Effectiveness Review Project,
Consumer Reports Health “translates” findings into consumer-friendly reports that are available for free. These reports identify drugs that are as effective and safe as others in its class but often available at a lower cost, as well as provide information about the underlying condition. These recommended drugs are often generic drugs, but in the case that a brand-name drug is superior to a lower-cost drug in safety or efficacy, it is recommended regardless of price. The reports are freely accessible at Consumer Reports Best Buy Drugs, and also available in a printed booklet. Fill out the form below to request a free booklet get mailed to you. Remember to include your address! 😊