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The Health Plan is pleased to provide the following information and links to assist you in finding prescription drug plans and assistance programs. Please be aware that the Health Plan does not monitor these Web sites and, therefore, cannot be held responsible for any information which may be contained in or omitted from them. In addition, by listing these sites, the Health Plan is in no way endorsing, recommending or otherwise promoting the benefit programs of these companies.
Many states offer a free or low-cost Pharmacy Program or discounted prescriptions to people without Rx coverage. Eligibility is based on need and family income, and, in some states, only seniors are eligible. Below are contact telephone numbers and information for the 6 more heavily participant-populated states:
|California||800 434-0222||Discount Program: Individuals eligible for Medicare can get their prescriptions at a Medi-Cal-participating pharmacy at a 10-40% discount.|
|New York||800 332-3742||Elderly Pharmaceutical Insurance Coverage (EPIC): Must be 65 or older and have an annual income of $35,000 or less if single or a combined annual income of $50,000 or less if married; Cost (if any) for Program is based on family income|
|New Jersey||800 792-9745||New Jersey offers two Programs - One is for seniors, the other for seniors and the disabled; Eligibility is based on family income|
|Florida||888 419-3456||Florida offers two programs - One is available to anyone on Medicare, the other is for low-income seniors|
|Illinois||800 624-2459||Pharmaceutical Assistance Program (PAP): Must be 65 or older, disabled or a widow/widower and meet income requirements|
|Texas||No Program||No Program|
Veterans and military retirees may be eligible for prescriptions and other health care benefits through the U.S. Department of Veteran Affairs. Information may be obtained by calling (877) 222-8387 or through their Web site: www.va.gov
Medicare Prescription Drug Plans (PDPs) are available for Medicare eligible retirees starting January 1, 2006. (Note: If you are in the SAG-Producers Health Plan, you already have prescription drug coverage that is more generous than the Medicare coverage; therefore, you should not enroll in a Medicare PDP, unless you qualify for Medicare’s limited income and resources provision.)
Some states offer a prescription drug benefit to people eligible for Medicaid.
Below are contact telephone numbers to Medicaid Offices in the 6 more heavily
|California (Medi-Cal)||888 747-1222|
|New York||800 206-8125|
|New Jersey||800 356-1561|
Children under age 19 not eligible for Medicaid may be eligible for free or
low-cost insurance through 'Insure Kids Now'. The nationwide toll-free number
for information on your state's guidelines is (877) 543-7669.
The nationwide toll-free telephone number for the U.S. Department of Health and Human Services, of which both Medicaid and 'Insure Kids Now' are a part, is (877) 696-6775, or visit their Web site: www.hhs.gov
Many pharmaceutical companies provide access to prescription medications-discounted or free of charge to patients who cannot afford to buy drugs at retail prices. Following are two Web sites with pharmaceutical company and program information (Please note: These are information-only sites; They do not offer programs themselves):
PBMs are private firms that contract with health plans or plan sponsors and specialize in claims processing and administrative functions involved with operating a prescription drug program. Some PBMs offer an individual pharmacy program. Be sure to check with any other health plan of which you are or have been a participant to inquire whether its PBM offers an individual pharmacy program. Listed below is the PBM used by entertainment plans that offers such a program. An annual enrollment fee may be required.
There are over 40,000 participating pharmacies, home delivery is available and members can receive a 12-40% discount off of cost. For additional information or to enroll, call Express Scripts at (877) 733-6765.
AIDS DRUG ASSISTANCE PROGRAMS (ADAPs) : ADAPs provide vital medications to low-income uninsured or underinsured people with HIV and AIDS.
|District of Columbia||202 332-2437|
|New Hampshire||800 752-2437|
|New Jersey||800 624-2377|
|New Mexico||800 545-2437|
|New York||800 542-2437|
|North Carolina||800 342-2437|
|North Dakota||800 472-2180|
|Puerto Rico||787 763-4575|
|Rhode Island||800 726-3010|
|South Carolina||800 322-2437|
|South Dakota||800 592-1861|
|West Virginia||800 642-8244|
*In the state of Vermont
this program is referred to as the AIDS Medication Assistance Program (AMAP).
American Association of People with Disabilities (AAPD): Members of this association are eligible to receive prescriptions through RPS Pharmacy, Inc. (mail order) at a 20-40% discount. AAPD's Web site is www.aapd.com.
National Organization for Rare Diseases, Inc. (NORD): Offers a medication assistance program to uninsured or under-insured people. A financial need application can be requested by calling (800) 999-6673.