January 14, 2003
DALLAS-Many senior adults today face the tragic reality of choosing between buying food or purchasing the prescription drugs they need to stay healthy.
While Medicare helps disabled and senior citizens afford hospital stays, outpatient procedures, doctor visits and other medical care, it generally offers no coverage for outpatient prescription drugs.
But help is available for seniors through a variety of avenues. The problem is that most people, including many doctors, are unaware of the programs offering assistance.
One of the goals of the Annuity Board is to promote and offer medical plans for Southern Baptist ministers, including many retirees, and to be an advocate for the senior adult population who is often the most negatively affected by the rising cost of health care.
"While the Annuity Board offers two Medicare supplement plans that include prescription drug benefits, we realize that the costs of any medical plan can be prohibitive to many seniors on fixed incomes," said Doug Day, executive officer of Benefit Services. "We are very concerned about those senior adults who can’t afford the prescription drugs they need.
"As an advocate for those seniors, we are spreading the word that help is out there for those who need it," Day said.
While Congress continues to debate adding a drug benefit to Medicare, the cost of prescription drugs continues to rise at an alarming rate. Many older adults simply cannot afford health insurance to supplement their Medicare benefits and thus have no coverage for prescription drugs.
With monthly prescription drug costs for some senior adults totaling in the hundreds or even thousands of dollars, many seniors can’t afford to fill all of the medicines prescribed by their doctors or may take less medication than prescribed to try to make their medications stretch farther.
In a poll conducted by AARP, 57 % of seniors without prescription drug coverage reported stretching medications, 52% said they sometimes skip filling prescriptions and 50% reported spending less on food so that they could purchase their medications.
Drug companies like Merck, Pfizer and Eli Lilly have implemented patient assistance programs to make their drugs affordable for seniors and disabled persons on Medicare. These programs are designed to help those who can’t afford their medicines obtain them free of charge or at a significant discount.
To qualify for most programs, seniors or disabled persons must be enrolled in Medicare, have no prescription drug coverage and meet annual income restrictions, typically $18,000 for singles or $24,000 for a couple. (Some programs allow a higher annual income.)
Through its patient assistance program, Merck has provided people with access to needed medicines for nearly 50 years. In 2001, the program provided over 2.5 million prescriptions free of charge to over 350,000 patients. Pfizer and Eli Lilly make any of their drugs available to eligible persons for only $15 and $12 respectively for a one month prescription.
Since most of the programs are sponsored by pharmaceutical companies, a patient must first identify the manufacturer of his or her medication, then contact the company for an application. If a person takes multiple drugs manufactured by different companies, it may be necessary to enroll in more than one program.
There are some helpful Web sites that can assist a senior adult trying to locate patient assistance programs for their specific prescription drugs and then get an application for the program. Medicare’s consumer information Web site, www.medicare.gov, offers information on these programs and a comparison of several. The National Council on Aging also offers a Web site, www.benefitscheckup.org, that helps seniors identify programs that may pay for some of the costs of their prescription drugs and may also help pay for healthcare, utilities and other essential service items.
At www.phrma.org, seniors can look up a specific drug by name or select a pharmaceutical company to find a list of the drugs available through the company’s program. For a $5 processing fee per drug application, The Medicine Program will assist a person in enrolling in the appropriate programs. For information and an application, call 1-573-996-7300 or visit their Web site at www.themedicineprogram.com.
In addition to the programs sponsored by individual pharmaceutical companies, disabled or senior veterans may be eligible for a discount prescription drug program through the Veterans Administration. Call 1-877-222-8387 for information.
Enrollment in most patient assistance programs is free but the process for getting enrolled can be confusing. Seniors may need to enlist the help of a friend or family member, or even an online service to get enrolled in the appropriate programs. While patient assistance programs are not the final solution to providing adequate coverage for prescriptions, they do offer some financial relief to seniors.