There are some financial assistance programs for MS medications. There are also income guidelines one must meet in order to be approved. Do they consider the high cost of health insurance and other health related expenses? Can one find out what maximum amount of income is usually approved?
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MSWorld has a list of programs and phone numbers listed here: http://www.msworld.org/forum/showthread.php?t=121313 Each program is different, but they basically break down into two groups; non-profit and for profit.
Non-profits often have limits listed on their website and are based on the federal poverty level. For profit companies do have legal requirements to meet, especially for individuals enrolled in government benefit programs. For uninsured individuals and private insurance holders, for profit organizations have much more latitude to create their own plans. Two years ago, most copay assistance programs were often capped at $25 or $40/month. Today, the MS medication marketplace is more competitive, and many companies now offer a copay assistance program with near $0 deductibles. Again most of these programs have income limits listed on their websites, but you may have to dig to find them.
Here's an example of what a non-profit group may have:- The MSAA's cooling program application states their requirement ceiling is "3x the federal poverty level." http://mymsaa.org/msaa-help/cooling/
Here are a few examples of what for-profit companies are doing:- The Novartis Patient Assistance Program (PAP) provides free medicine to low-income, uninsured patients. To qualify, you must be a US resident, receive an income less than 500% of the Federal Poverty Level, and must not have insurance (public or private) or any third-party prescription coverage. http://www.extavia.com/info/Treatmen...tavia-cost.jsp
- For daily COPAXONE® 20 mg your co-pay could be lowered to $35 per month out of pocket. With these common restrictions, "The offer is not valid for patients covered in whole or in part by Medicaid, Medicare, TRICARE, or any other federal or state government pharmaceutical assistance plan or program (regardless of whether a specific prescription is covered), or by private health benefit programs that reimburse for the entire cost of prescription drugs. Use of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or private third-party payor. This offer is void where prohibited by law, taxed, or restricted. No additional purchase is required. This offer is valid only at participating pharmacies and may be changed or discontinued at any time without notice. This program is not health insurance."https://www.copaxone.com/shared-solu...opaxone-co-pay
- Biogen's Copay Assistance program for Tecfidera gathers financial information as part of their screening. For patients in private insurance plans there are no income limits. Otherwise, the Tecfiera copay program has similar restrictions to Copaxone's.
http://www.tecfidera.com/support/cost
If you tell us what company or medication you are interested in, we may be able to give you more specific information. Generally, most for profit plans are generous. They are keenly aware of the high-cost of healthcare because they are a large part of that cost. The plans are designed to help the patient to meet your deductible and maximum out of pocket requirements so the insurance company can pay the the balance. Thanks and have a great day.
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