BenefitsCheckUp quickly finds federal, state and private benefit programs available to
help you save money on prescription drugs, health care, utilities, taxes, and more. Click
below to give us some basic information and view a personal report on the benefits you may
qualify for. http://www.benefitscheckup.org
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AARP's Discount Mail Order Program. Call 800-289-8849 or go to this link. http://www.aarppharmacy.com/
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Disability Resources. A nonprofit org. that provides information about resources for
independent living. Resources listed by by state. http://www.disabilityresources.org/
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Partnership for Prescription Assistance. For a free directory, call 800-762-4636 or go to:
http://www.helpingpatients.org/
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Needy Meds. A site devoted to helping you find the medication you need for free or at a
cost you can afford. http://www.needymeds.com/
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Veteran and MIlitary Benefits. If you are a veteran call 877-222-8387 or go to: http://www.va.gov/
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Patient Assistance Directory Pharmaceutical Research & Manufacturers of America
Call for booklet: 1-888-477-2669 . At least 42 companies will provide free medicine to
uninsured patients in need. Your Doctor must attest it would be a hardship for you to buy
them.
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Purdue Pharma Patient Assistance Program P.O. Box 66547 St. Louis, MO 63166-6547 1-(800)
599-6070 (phone) Physician requests should be directed to: 1-(800) 599-6070 (phone) Drugs
covered: Oxycontin, OxyIR
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New York State residents can join EPIC if they are 65 or older, and have an annual income
of $35,000 or less if single, or $50,000 or less if married. Seniors who receive full
Medicaid benefits or have other prescription coverage that is better than EPIC are not
eligible for EPIC benefits. EPIC is a cost sharing program. Seniors with moderate incomes
pay a low quarterly fee, and participate in the Fee Plan. Seniors with higher incomes meet
an annual deductible, and participate in the Deductible Plan. Those who pay a fee or meet
their deductible make a copayment at the pharmacy when purchasing prescriptions.
Click here to visit the program's web site. http://www.health.state.ny.us/nysdoh/epic/faq.htm
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Michigan
Contact Information 1-(866) 755-6479 (phone)
MiRx Card Application Form (www.michigan.gov/ documents/MiRx_brochure_
150dpi_103392_7.pdf)
There is no age limit to participate in the MiRx Card program. When individuals fill out
the application, they should include all eligible members of their family or household.
Once your application is completed and processed, eligible applicants will receive their
own MiRx card in the mail within two weeks along with a list of participating pharmacies
in their area. To be eligible, applicants must: * Be a resident of the State of Michigan *
Have no other prescription drug coverage * Have an income level at or below the state¹s
median income level.
Beneficiaries of the MiRx Card program will save as much as 20 percent off the retail
prices they would normally pay as a cash customer. The MiRx Card program is free. There is
no cost for the card. There is no cost to enroll in the program. And, the MiRx Card is
easy to use. MiRx Card holders will take their prescription and their MiRx card to their
local participating pharmacy. The pharmacist will fill the prescription and charge the
MiRx discounted price. http://www.michigan.gov/documents/MiRx_brochure_150dpi_103392_7.pdf
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McNeil Pediatrics, A Division of McNeil-PPC, Inc.
Contact Information Patient Assistance Program P.O. Box 221857 Charlotte, NC 28222-1857
1-(800) 652-6227 (phone) 1-(888) 526-5168 (fax)
Physician should contact: Patient Assistance Program P.O. Box 221857 Charlotte, NC
28222-1857 1-(800) 652-6227 (phone)
Drugs covered by program: Concerta Extended-Release Tablets CII, Flexeril Tablets,
Pancrease, Pancrease MT Capsules
Program will ensure that McNeil Consumer and Specialty Pharmaceuticals prescription
products Concerta® (methylphenidate HCL) Extended-Release Tablets CII; Flexeril®
(cyclobenzaprine HCL) Tablets; Pancrease® MT (pancrelipase) Capsules will be provided
free of charge to those U.S. residents who lack access to prescription drug coverage and
meet specific financial criteria. Medicare LIS (Low Income Subsidy) eligible patients are
not eligible to receive assistance through the Patient Assistance Program. Patients
receiving benefits under a Medicare Part D prescription drug plan are not eligible to
receive assistance through the Patient Assistance Program, however program eligibility
exceptions for Medicare Part D enrollees based on significant financial or medical need
will be considered. If necessary, patients may reapply after initial supply.
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Massachusetts Customer Service Center
Contact Information: MassHealth Customer Service Center Central Processing Unit PO Box
290794 Charlestown, MA 02129-0214 1-(800) 841-2900 (phone) Medical Benefit Request
(www.mass.gov/Eeohhs2/ docs/masshealth/appforms/ mbr.pdf)
The Division of Medical Assistance manages MassHealth. MassHealth pays for health care for
certain low- and medium-income people living in Massachusetts who are under age 65 and who
are not living in nursing homes or other long-term-care facilities.
These include:
- families with children under age 19
- children under age 19
- pregnant women
- people out of work for a long time
- disabled people
- adults who work for a qualified employer
- people who are HIV positive
The Division offers health-care benefits directly or by paying part or all of your
health-insurance premiums. Certain persons aged 65 or older may also be eligible for
MassHealth if they are parents or caretaker relatives of children under age 19, or are
disabled and working 40 or more hours a month. The Division will decide if you are
eligible and give you the most complete coverage that you qualify for.
Visit the program's web site. http://www.mass.gov/Eeohhs2/docs/masshealth/appforms/mbr.pdf
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Louisiana Elderly Affairs
Contact Information: Office of Elderly Affairs P.O. Box 80374 Baton Rouge, LA 70898
1-(225) 342-7100 (phone) 1-(225) 342-7133 (fax)
Physicians should direct requests to: Office of Elderly Affairs Office of the Governor
P.O. Box 80374 1-(225) 342-7100 (phone)
Who's covered.
Seniors age 60 and older who are legal Louisiana residents.
Seniors with an income below 300% of the poverty level.
Seniors with a chronic illness taking prescribed daily medications for the condition.
Seniors who do not have insurance covering medications. Seniors who have not voluntarily
cancelled state/federal prescription drug programs or a private reimbursement plan within
6 months.
SenioRx does not provide assistance for obtaining short-term medicines to meet acute
needs, including antibiotics. http://www.louisianaseniorx.org/
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KCHIP in Kentucky
PO Box 1704 Louisville, KY 402011-(877) 524-4718 (phone) http://chs.state.ky.us/kchip/
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Kansas Healthwave Program
Contact Information: Healthwave PO Box 3599 Topeka, KS 66601 1-(800) 792-4884 (phone)
Applicant must be a resident of Kansas. http://www.kansashealthwave.org/
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Illinois Access to Care.
Contact Information: Access to Care 2225 Enterprise Drive Suite 2504 Westchester, IL 60154
1-(708) 531-0680 (phone) 1-(708) 531-0686 (fax)
Your family must be at or below 200% of the federal poverty level, you may not have health
insurance (or a deductible of $500 or more per person), you must be ineligible for
Medicaid or Medicare and residence in suburban Cook County There are Non-Refundable Annual
Enrollment Fees: $20 for one person, $40 for two people, $50 for three or more people in
one family. Fees are based on family size of eligible applicants. A family is defined as
husband, wife, and number of children under age 21. To register for an appointment, call
708-531-0680. Registration is also available by mail.
http://www.accesstocare.org/
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GlaxoSmithKline
Contact Information 1-(866) 728-4368 (phone)
Products covered: Advair Diskus, Advair HFA, Agenerase, Albenza, Amerge, Amoxil, Arixtra,
Augmentin ES, Augmentin XR, Augmentin, Avandamet, AVANDARYL Tablets, Avandia, Avodart,
Bactroban Cream, BACTROBAN Nasal, Bactroban Ointment, Beconase AQ, Ceftin, Combivir, COREG
CR, Coreg, Daraprim, Dexedrine, Dyazide, Epivir, Epivir-HBV, Epzicom, Flonase, Flovent,
FLOVENT HFA w/dosage counter, Fortaz, Imitrex, Lamictal, Lanoxicaps, Lanoxin, Lexiva,
Lotronex, Malarone, Mepron, Parnate, Paxil CR, Paxil IR, RELENZA, Requip, Retrovir,
Serevent Diskus, Timentin, Trizivir, Valtrex, Ventolin, HFA, VERAMYST™ Nasal Spray,
VESIcare, Wellbutrin SR, Wellbutrin XL, Wellbutrin, Zantac Efferdose, Zantac, Ziagen,
Zinacef, Zofran ODT, Zofran, Zovirax, Zyban.
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Program is Advocate-based. All contact for the Patient is through an Advocate. Please
visit website (www.BridgesToAccess.com) for more information. GSK Access, a new Patient
Assistance Program, began in January 2007 for low income and disabled Medicare Part D
participants. Please visit the website (www.GSK-Access.com) for more details.
http://www.bridgestoaccess.gsk.com/
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Eli Lilly and Company
Contact: Lilly Cares PO Box 230999 Centerville, VA 20120 1-(800) 545-6962 (phone)
Physician should direct requests to: Lilly Cares P.O. Box 230999 Centreville, VA 20120
1-(800) 545-6962 (phone)
Drugs covered: Cymbalta, Evista, Humalog, Humulin, Prozac Weekly, Prozac, Reopro,
Strattera, Symbyax, Zyprexa.
Lilly Cares Application
Patients must be legal U.S. residents. Eligibility is determined on a case-by-case basis.
Eligibility is based on the patient's income level, and lack of third- party drug coverage
(including Medicare Prescription Drug Benefit, Medicaid, private Rx insurance,
government-subsidized clinics, and other government, community, or private programs).
Inpatients and those who can obtain drug reimbursement from any source are not eligible.
Requests for replacement drugs cannot be honored. Medications are provided directly to the
physician for dispensing to the patient. Quantity of supply is dependent upon type of
product being prescribed, but usually in 4 month supply. All Lilly medications must be
used as recommended in product labeling. Enrollment period is for 1 year, and refills are
requested by Fax Refill Form(included in the shipment) by the prescriber. Final
eligibility can only be determined by completing an application.
https://www.pparx.org/resources/2007-05-15.Eli_Lilly_and_Company.Lilly_Cares.22.pdf
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Delaware Prescription Assistance Program
Lewis Building, DHSS Campus, Herman Holloway Sr. Campus 1901 N. DuPont Highway New Castle,
DE 19720 1-(800) 996-9969 (phone)
You must reside in the state of Delaware and be at least 65 years old or qualify for
Social Security Disability benefits. Your income must be at or below 200% of the Federal
Poverty Level. Individuals with income over 200% of FPL can qualify if they have
prescription costs exceeding 40% of their income.
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