Prescription Drug Options for the Uninsured

Prescription drugs are a fundamental component of quality health care. Nevertheless, nearly 42 million Americans have no health insurance coverage and it is believed that about one third of Medicare patients have no insurance coverage for prescription drugs. Prescription drugs are ordinarily quite expensive and those, such as the elderly, who need multiple medications or high cost medications, have difficulty acquiring the medications that are needed to maintain their health.

In response to the concerns over the high out of pocket cost of prescription drugs for the uninsured most states have devised a number of ways to make discount purchasing programs more available to persons who are uninsured.

As for October 2004 over 20 states had established subsidized prescription drug coverage programs for the elderly and uninsured that meet certain criteria. Person’s who meet the criteria would be expected to pay an enrollment fee, a co-pay and, in some cases a deductible. The criterion for the programs is normally based on age, income, residency, and physical disability. Most states require enrollees to have an annual income below $14,000 to $18,000.

One way that states are working to expand these discount purchasing programs for prescription drugs is through the Public Health Service Drug Discount Program , authorized un section 340B of the Public Health Service Act that requires drug manufactures that participate in the Medicaid program of each state to provide discounts or rebates for 16 specific federal health programs. Among some of the entities and individuals who benefit from the Public Health Services Act are homeless health centers; family planning clinics and AIDS drug assistance programs. If you are a patient who qualifies for care through one of these groups then you will qualify for the discounted drugs made available by the Public Health Services Act.

Earmarking state funds, specifically for persons who are without health insurance due to economic factors or due to the fact they are uninsurable because of a disability is another way some states are handling the problem. The state of Tennessee uses state funds to contract with Blue Cross, Blue Shield to offer its uninsured or uninsurable residents a low cost health care plan.

Most states are broadening their qualifications for Medicaid programs to give the uninsured or uninsurable a better chance at access to state funded health insurance programs. Thirty-five states are now offering Medicaid programs that either include prescription drug coverage or assistance for elderly people through their Medicare coverage.

Some who benefit from these knew programs are those who are older, blind or disabled in some way. In most states if your income is below the poverty level you will qualify for full Medicaid which could cover either prescription drugs or full health care benefits.

Medicare beneficiaries with incomes up to 175% of the federal poverty level are eligible for what is called a “Buy In” program. These programs do not provide coverage for prescription drugs but they do help with the out of pocket costs of prescription drugs.

One proposed federal strategy would be to permit pharmacies and wholesale dealers of prescription drugs in the United States to reimport drugs manufactured in the country and exported to certain other countries where price control or economic constraints limit the price of medications. In other words, drugs that are made in the U.S. and sold to other countries where there is not the same huge mark up could be resold to the U.S. at a lower cost which, in turn could then be sold the consumers at a greater discount.

The theory behind this is that lower cost medications by pharmacies and wholesalers will result in less expensive medications for consumers. One has to wonder though, why, with 42 million prescription drug consumers here in our own country why we are not given first opportunity at wholesale drugs instead of waiting for exported drugs to be imported back to the very place they came from.

We have busloads of consumers traveling to Canada on a daily basis to buy prescription drugs. Drugs that were made here in the U.S. but sold to Canada for less than an American consumer would be able to purchase them for. One has to stop and ponder why drug trade with Canada and other foreign countries is more important than selling at a lesser cost to our own uninsured or uninsurable consumers.

Bottom line�if you are a patient without prescription drug coverage and you have limited financial means, the cost of medications can be overwhelming. If you find yourself in this position and do not qualify for any state run programs that would assist in the cost of medications there are some options.

Most importantly you should discuss your situation with your Doctor. He/She will be able to prescribe a less expensive drug that will not compromise your health. Your Doctor will also know of any patient assistance programs that would be available through either your state or local community government. Two good places online to check out would be www.rxassist.com and https://www.pparx.org/Intro.php. RxAssist in a non-profit organization set up to assist qualified patients with the cost of medications. PPARX is an organization that helps patients find programs that might possibly be of assistance in defraying the cost of medications.

Drug prices can vary tremendously from pharmacy to pharmacy so, when purchasing prescription medications it pays to shop around and compare prices. You will also get a better price per tablet or pill if you buy a full 90-day supply. Request that your Doctor write your prescription so that it can be filled this way and you can take advantage of the cost per pill savings. Unless it is something you have had a problem with in the past and you are able to take the generic form of a medication always request that your pharmacist give you the generic.

Another avenue to consider is buying through pharmacies that carry high volumes of medications. This would involve purchasing medications via the Internet or through mail order. The following are some sites doing business through the Internet. It will be necessary to have your Doctor call your prescription in to them. Prices tend to be excellent and shipping fees are nominal at best. In general the best prices will be obtained if you order, once again, at least a 90 day supply of medication.

Certified, online pharmacies include:

CVS.com (www.cvs.com)
Drugstore.com ( www.drugstore.com)
Familymeds.com (www.familymeds.com)
MerkMedco Managed Care L.L.C. (www.merck-medco.com)
Teldrug.com (www.teldrug.com)

Non-Certified, online pharmacies include:

Allmark Drugs (www.bestrxprices.com)
RxUSA (www.rxusa.com)

One of the most distressing things an individual can face is a debilitating illness. Add to that the fact that you can’t afford the medication needed to recover or maintain your health and a certain amount of anxiety is produced. Thanks to many state run programs, Patient Assistance Programs and, online bulk pharmacies some of this anxiety can be reduced. I suffered a car accident in 2002 and received an injury to a kidney that has left me “uninsurable.” Thanks to the care and concern of my Doctor I was able to find a program that has covered most of the cost of my healthcare and medications. Your Doctor is your best source of information and the knowledge that you live in a country that really does take care of it’s own. Might not seem that way at times but if you look hard enough you will find the assistance needed.

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