IMPORTANT ANNOUNCEMENT: PHA is receiving a high volume of calls related to help paying for PH medications. We understand how critical these calls are, and we want everyone to get the information they need as quickly as possible. Please note that PHA does not offer copay or premium assistance. Individuals seeking copay assistance should call the company that makes their PH therapy. A list of those phone numbers and related resources is available below.
With or without insurance, pulmonary hypertension (PH) treatments can be costly. If you are seeking help covering the co-pay for your pulmonary hypertension therapy in 2018 you may wish to take some or all of the following steps. This list represents resources PHA is aware of that are likely to be applicable to many in the PH community. It is by no means an exhaustive list of state or local assistance that may be available in your area.
If you believe that you are at risk for running out of your PH therapy early in 2018, contact your PH care team now. Do not wait until you are completely out of medication.
UPDATE: Drug Companies May Assist Former CVC Clients
On January 4, 2018 the Department of Health and Human Services (HHS) issued a letter telling drug companies that they are permitted to provide free medication in 2018 to “federal healthcare program beneficiaries who were receiving cost sharing support for those drugs from CVC as of November 28, 2017.” For regulatory reasons drug companies typically only provide assistance to individuals with commercial or private insurance or those who are uninsured. In this case, HHS is making an exception for individuals with Medicare and other federally funded health insurance who were receiving assistance from the Caring Voice Coalition in November 2017. The HHS letter says only that drug companies may provide free medication if they wish, not that they are required to do so. Bloomberg News reported on these developments here.
Non-profit charitable assistance funds primarily support individuals with government-funded health insurance. Those with group or private insurance should also review the manufacturer assistance programs in the next tab. PHA is not aware of any non-profit providing support for health insurance premiums at this time.
None of the financial assistance funds for adult patients with PH listed below are currently accepting new applications. PHA will continue to update this page and announce updates through PHA News, a weekly e-newsletter, if there is a change to the status of any of these funds. Sign up for PHA News here.
- Patient Advocate Foundation (PAF) – The Patient Advocate Foundation (PAF) assistance fund for new and renewal patients with medicare, medicaid or military benefits is not currently accepting applications.
- The Assistance Fund – recently added pulmonary hypertension to their list of covered diseases, however they are not currently accepting applications. Check fund status at https://tafcares.org/patients/covered-diseases/
- Good Days – re-enrolling those who received a grant in 2017 and also have Medicare coverage
- Caring Voice Coalition – The CVC will not open financial assistance for any disease fund in 2018 per an announcement made on January 4, 2018.
- Patient Services Inc – not currently accepting 2018 applications
- PAN Foundation: not currently accepting 2018 applications.
Many pharmaceutical companies or specialty pharmacies sponsor drug-specific assistance programs to help patients navigate the reimbursement process.
PAPs are designed to make it as easy as possible to get your treatment by providing free or discounted drugs to low-income, underinsured or uninsured patients who meet specific guidelines. Manufacturers may also offer other types of general support programs, providing additional education, support and financial assistance.
Companies update these programs on an ongoing basis so individuals seeking assistance may wish to call even if they do not expect to qualify.
After exhausting the options reference below, consider contacting the specialty pharmacy that delivers your PH medication.
- Accredo/CuraScript/ExpressScripts: 1-866-FightPH (1-866-344-4874)
- Cigna Tel-Drug: 1-855-326-7463
- CVS/Caremark: 1-877-242-2738
- Humana Specialty Pharmacy: 1-855-478-8405
- Briova/OptumRx: 1-855-856-0536
- Walgreens/Medmark: 1-888-347-3416
Your state legislators and your U.S. senators and representative are all potential sources of help and information. They may be familiar with state-specific financial assistance resources for medication costs or other types of expenses.
- To contact your U.S. senators and representative, visit PHA’s action alert.
- To contact state legislators, visit your legislature’s website: https://www.congress.gov/state-legislature-websites
www.Benefits.gov and your state website (usually www.statename.gov) have additional information about government-funded assistance programs. For example, Medicaid, the Children’s Health Insurance Program (CHIP), rent and utility assistance, child care assistance and supplemental income.
If you use Medicare, you may wish to explore a program called “Medicare Extra Help” which provides reduced prescription drug costs for low-income Medicare recipients: https://www.ssa.gov/benefits/medicare/prescriptionhelp/.