Obtaining Health Care
HEALTH INSURANCE PROGRAMS
Pre-Existing Condition Insurance Plan
Turned away because of your illness?
If you’ve been denied health coverage due to a pre-existing condition and have gone at least six months without insurance, the Affordable Care Act created the Pre-Existing Condition Insurance Plan for you.
(866) 717-5826 | pcip.gov
Medicaid and the Children’s Health Insurance Program
Unable to afford health insurance?
If you have limited income and resources, you may be eligible for the Medicaid program(s) in your state. The Affordable Care Act increases coverage greatly for those in need come 2014 but, until then, here is a place to start:
Clinical Trials
Interested in participating in trial studies for free?
You may be eligible for one of the clinical trials currently in progress. Speak with your doctor as there are potential pros and cons with any new, advanced treatment.
Browse through the trials by disease state and location:
Federally Qualified Health Centers
Didn’t find one of the programs above to help with obtaining healthcare?
Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income.
Health centers provide:
- checkups when you’re well
- treatment when you’re sick
- complete care when you’re pregnant
- immunizations and checkups for your children
- dental care and prescription drugs for your family
- mental health and substance abuse care if you need it
Health centers are in most cities and many rural areas. Search their database:
(877) 464-4772 | findahealthcenter.hrsa.gov
Didn’t find a low cost clinic in the database above? Look at the Still’s page on the site.
Healthcare.gov
Ready to dive into the overall pool of U.S. healthcare info?
At Healthcare.gov, U.S. patients can learn about the healthcare system as it currently exists, the benefits the Affordable Care Act has brought us, and the benefits to come in 2014.
ASSISTANCE PAYING FOR CARE
Healthwell Foundation
Are you on Medicare but can’t afford your autoimmune disease healthcare?
Or, with or without Medicare, do you have Systemic Lupus Erythematosus (SLE), Chronic Gout, or Post-Menopausal Osteoporosis … and can’t afford your healthcare?
Established in 2003, the Healthwell Foundation is a 501(c)(3) non-profit organization that provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments.
Over 44,000 patients assisted in 2011. 21,000 callers assisted each month. Over $144 million awarded to patients in 2011 alone.
(800) 675-8416 | healthwellfoundation.org
Co-Pay Relief
Do you have prescription coverage (including Medicare Part D) but can’t afford the co-pays for your Rheumatoid Arthritis (RA), Chronic Pain, or Osteoporosis medications?
The Co-Pay Relief Program (created by the Patient Advocate Foundation) provides direct financial support for prescription co-pays to eligible, insured patients.
Eligibility requirements:
- patient should be insured and insurance must cover the medication for which patient seeks assistance
- patient must have a verified diagnosis of disease
- patient must reside and receive treatment in the United States
- patient’s income must fall below 500% of the Federal Poverty Level
(866) 512-3861 | copays.org
Patient Access Network Foundation
Do you have prescription coverage but can’t afford the co-pays for your medication?
Established in 2004, the Patient Access Network Foundation is a 501(c)(3) non-profit organization that provides eligible patients with co-payment assistance through 41 disease-specific funds that give them access to the treatments they need.
Eligibility requirements:
- patient is insured and insurance covers the medication for which the patient seeks assistance
NOTE: Some disease funds require Medicare coverage - medication must treat the disease directly
- patient’s income must be below a designated percentage of the Federal Poverty Level, depending on disease fund requirements
- patient is prescribed a high cost drug for the disease, depending on disease fund requirements
- patient must reside and receive treatment in the United States
The group has provided 132,000 underinsured patients with over $186 million.
(866) 316-PANF | panfoundation.org
(866) 316-7263
Chronic Disease Fund
Do you have prescription coverage and Exacerbations of Lupus but can’t afford medication co-pays or travel expenses (when necessary) to receive treatment?
Established in 2005, the Chronic Disease Fund is a 501(c)(3) non-profit organization that helps eligible patients with chronic disease, cancer and other life-altering conditions obtain the life-saving medications they need.
Potential benefits:
- patient program monitoring
- co-pay assistance
- air, car and lodging expense assistance when traveling for treatment
The group has provided patients with over $600 million.
NOTE: The group lists assistance programs for Rheumatoid Arthritis (RA), Psoriatic Arthritis, and Psoriasis. HOWEVER, as of May 2012, those programs are not open to new applicants. This could change and the programs open up in the future. If you notice a change in status from what is listed here, please let us know at the bottom of this webpage.
(866) 316-PANF | cdfund.org
(866) 316-7263
The Assistance Fund
The Assistance Fund has two financial aid programs. First, the Co-pay Assistance Program provides eligible patients with funds to cover certain out-of-pocket costs associated with their drug therapy.
Second, the Premium Assistance Program assists those who have health insurance but need help with the cost of their individual insurance premiums. The program is designed to assist patients who elect to pay out-of-pocket for private, independent or COBRA insurance coverage.
HOWEVER, their programs only current help patients with Multiple Sclerosis, Idiopathic Parkinson’s, and Cystic Fibrosis. If you notice that the group adds programs for arthritis, autoimmune diseases, psoriasis or osteoporosis, please let us know at the bottom of this webpage.
(877) 968-7233 | theassistancefund.org
FREE AND REDUCED MEDICATION ASSISTANCE
Partnership for Prescription Assistance
Looking for a place to start?
The Partnership for Prescription Assistance (PPA) will help you navigate the many free and reduced price drug programs out there.
Program directories include:
- free or low-cost health clinics in your area
- public assistance programs (e.g. Medicaid, CHIP)
- private assistance programs
The PPA has assisted nearly seven million people get the medicines they need for free or nearly free.
(888) 4PPA-NOW | pparx.org
(888) 477-2669
Together Rx Access
Don’t have prescription drug coverage?
Pharmaceutical companies joined together and created this discount card program. It’s free to get and free to use.
Eligibility requirements:
- no prescription drug coverage
- not eligible for Medicare
- have household income equal to or less than:
Single person Family of 2 Family of 3 Family of 4 Family of 5 $45,000 $60,000 $75,000 $90,000 $105,000
(800) 444-4106 | togetherrxaccess.com
ENcourage Foundation
Have little or no prescription drug coverage — and taking or thinking of taking Enbrel?
ENcourage Foundation is a nonprofit patient assistance program supported by Amgen and Pfizer that provides Enbrel (etanercept) at no cost to qualifying patients.
Eligibility requirements:
- must be U.S. resident
- demonstrate financial need
- have no or limited drug coverage
Qualifying Medicare part D patients may also be eligible.
(800) 282-7752 | encouragefoundation.com
ENBREL Support Card
Have prescription drug coverage — and taking or thinking of taking Enbrel?
For eligible patients, the ENBREL Support Card is a card to be presented to your pharmacist each time medication is picked up.
Potential benefits:
- 6 months at no out-of-pocket cost to you
- $10 or less out-of-pocket per month thereafter
- Support for your Enbrel co-pay or co-insurance, and prescription deductible
(888) 4-ENBREL | enbrelsupport.com
(888) 436-2735
Pfizer Helpful Answers
Have little or no prescription drug coverage — and taking or thinking of taking a Pfizer or King medication?
Pfizer offers a family of direct financial assistance programs to eligible patients.
Potential benefits:
- helps patients save money on Pfizer or King’s medications, “no matter their age or income”
- people with limited income might qualify to get their Pfizer or King medicines for free
(866) 706-2400 | pfizerhelpfulanswers.com
Lilly TruAssist
Have little or no prescription drug coverage — and taking or thinking of taking a Lilly medication?
Lilly TruAssist collects all patient programs that offer assistance in obtaining Lilly medications.
Last year, Lilly helped almost 230,000 patients.
(855) LLY-TRUE | lillytruassist.com
(855) 559-8783
Humira Protection Plan
Have little or no prescription drug coverage — and taking or thinking of taking Humira?
Regardless of your current insurance or employment status, Humira offers guidance and support to help you access the treatment your doctor has prescribed.
(800) 4HUMIRA | humira.com
(800) 448-6472
NeedyMeds
NeedyMeds is a 501(c)(3) non-profit organization that aims to provide information on all low-cost health clinics across the U.S.
The 10,269 clinics in their database are free, low cost, low cost with a sliding scale based on income, or offer some type of financial assistance. Search their database:
needymeds.org/free_clinics.taf
NeedyMeds Drug Discount Card
Didn’t find one of the free and reduced price programs above to help with over-the-counter medications?
The drug discount card cannot be used with insurance, but it can be used instead of it. There may be no savings for certain drugs, including many inexpensive generics. NeedyMeds Drug Discount Card: needymeds.org Database of other organizations’ and individual U.S. state drug discount cards: needymeds.org/indices/discountcards.htm
LEGAL ASSISTANCE
Patient Advocate Foundation
Unable to acquire or retain insurance, or employment? In crisis with medical debt?
Established in 1994, the Patient Advocate Foundation is a 501(c)(3) non-profit organization that works one-on-one with individuals, aiming to provide effective mediation and arbitration services to patients to remove obstacles to healthcare including medical debt crisis, insurance access issues and employment issues for patients with chronic, debilitating and life-threatening illnesses.
Their services are free.
(800) 532-5274 | patientadvocate.org
PATIENT ADVOCACY
Drug Watch
Drugwatch.com is updated constantly with new information about research breakthroughs, clinical trials, recalls, and warnings from the U.S. Food and Drug Administration (FDA). We do our best to make consumers aware of the risks of certain medications and medical devices, to give them a better chance for quality of life.
http://www.drugwatch.com/news/
Need information on how to obtain your medical records in your state, get Social Security Disability Insurance, successfully file insurance appeals, and more?
Established in 2005, the Advocacy for Patients with Chronic Illness organization aims to provide legal information to all patients.
They also publish “Know Your Rights — A Handbook for Patients With Chronic Illness.” There is a $30 fee for the book, though we’re finding it invaluable, with state-by-state guides, legal explanations in easy-to-understand layman’s terms, sample form letters, and more.
Their services are free, though they accept donations in order to help future patients.
(860) 674-1370 | advocacyforpatients.org
