Northwest Missouri Area Agency on Aging

Your Trusted Source of Unbiased Information and Services Since 1973

 
         

 

 

MO-RX HAS ENDED!  NOW WHAT?

 
 

 

 

                                                                         

IMPORTANT!  This does not change your current Medicare Part D coverage!

You are not required to make any changes at this time.  MoRX had been paying 50% of a recipient’s out-of-pocket costs on all medications covered by their Part D plan.  If you fill prescriptions online, you will not be affected. 

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 (This does not apply to Medicaid recipients or those who are on a Medicare Savings Program, because you will continue to receive MoRX benefits)

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OPTIONS

-- UNTIL THE END OF AUGUST-- Since Missouri’s Patient Assistance Program (Mo-RX) ended, those who are affected have a special Open Enrollment to run Medicare Part D plan comparisons, if you wish to do so.  This is normally only available from October 15 through December 7.  We may be able to find a plan that will save you money.  You can wait until normal open enrollment in the fall, if you wish. 

You do not have to change, or even run the comparison, if you do not want to at this time.

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--We can help you determine if you are eligible for Extra Help with your Medicare premiums.  There are income- and asset-based programs that can help, depending on individual circumstances.  We have a worksheet we can send to you with the current income/asset guidelines, or it is available HERE

Some people may even qualify for Medicaid, due to changes in income and asset limits effective July 1.

 

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Reference for Inhaler Assistance

Program

Inhalers (not an all-inclusive list)

Eligibility Requirements

GSK Patient Assistance Program

1-866-728-4368

Advair HFA and Diskus, Flovent HFA and Diskus, Ventolin HFA, Anoro Ellipta, Breo Ellipta

Spent $600 on Rx this calendar year

Income limits Single $2512/mo,

 Couple $3383/mo

 

Boehringer Ingelheim Cares Foundation

1-800-556-8317

Spireva Handihaler and Respimat, Combivent Respimat, Atrovent HFA, Stiolto Respimat, Striverdi Respimat

Income <200% of FPL

Copy of LIS denial letter if within 1 year

LIS denial not a requirement

 

AstraZeneca Prescription Savings Program

1-800-292-6363

Symbicort

Current year OOP on Rx >3% of annual household income

Annual income limits (single $35K, couple $48K)

 

Merck Patient Assistance Program

1-800-727-5400

Dulera, Proventil HFA

Income <400% of **FPL

 

PAN Foundation

1-866-316-7263

(See Note Below)

All the above plus Proair and QVAR

Benefit is reimbursement of copays up to $1400 per year

Diagnosis MUST be Asthma

COPD and Emphysema diagnosis are not eligible

Income <400% of FPL

 

**Federal Poverty Level 2017:  200% Single $2050/mo, Couple $2746/mo    400% Single $4100/mo, Couple $5492/mo

PAN Foundation – As of July 15, 2017, the Asthma Fund is open for new enrollees, but could close at any time and is dependent on funding.  This is a charity program and operates different than a manufacturer’s program.  Assistance starts on the approval date and continues for 12 months.  Eligible expenses incurred up to 90 days prior to the approval date may be submitted for reimbursement.  There are multiple options for submitting a claim.  Applications are online or by phone (possibly to get a paper application).

NOTES:  It is advisable for the beneficiary  to call the program prior to beginning the application process.

Not all forms of the medication may be available in the program.

There may be multiple options for enrolling (online, phone or paper application).

Programs may have different policies for quantities and methods of delivery of Rx.

There may be multiple options on acceptable documentation to be sent with the application

 

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Below are some websites that provide assistance for people who need help paying their high-cost prescriptions.  We strongly advise you to check them carefully, because there are several options: 

http://www.rxassist.org

https://panfoundation.org/index.php/en/

https://www.healthwellfoundation.org/

http://www.rxoutreach.org

http://needymeds.org

Insulin Assistance

 

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--Patients could search for a local public health center that might have a sliding scale pharmacy, with costs based on income, at

https://www.mo-pca.org/find-a-health-center

 

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--Patients may want to speak to their doctor or pharmacist to see if there are other options,

especially for higher-cost prescriptions.

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--Veterans might inquire about getting their prescriptions through the VA

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--Patients can look into the cost of filling their prescriptions through their Part D Insurance company’s preferred mail order site,

especially during the coverage gap (donut hole)

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--Patients may wish to shop around and compare costs of higher-cost prescriptions.

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--Patients could search for a local public health center that might have a sliding scale pharmacy, with costs based on income at

https://www.mo-pca.org/find-a-health-center

 

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NORTHWEST MISSOURI AREA ON AGING

ALBANY MO

888-844-5626 or 660-726-3800

660-726-4113 fax

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