Rx Resource Guide

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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.

State Pharmaceutical Assistance Programs

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:

State Contact Number Information
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 Administration

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

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.)

Medicaid (Low-income, Need-based)

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 participant-populated states:

State Medicaid Office
California (Medi-Cal) 888 747-1222
New York 800 206-8125
New Jersey 800 356-1561
Florida 888 419-3456
Illinois 800 252-8635
Texas 800 964-2777

Insure Kids Now

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

Pharmaceutical Companies

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):

  • The Pharmaceutical Research and Manufacturers of America (PhRMA)
    www.phrma.org (then select 'Directory of Prescription Drug Patient Assistance Programs') (800) 762-4636
  • NeedyMeds.com
    www.needymeds.com (then select 'Program List')

Pharmacy Benefit Managers (PBMs)

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.

Express Scripts

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.

Charitable Organizations

AIDS DRUG ASSISTANCE PROGRAMS (ADAPs) : ADAPs provide vital medications to low-income uninsured or underinsured people with HIV and AIDS.

State Phone Number
Alabama 800 228-0469
Alaska 800 478-2437
Arizona 602 230-5819
Arkansas 501 661-2118
California 888 311-7632
Colorado 800 858-2437
Connecticut 800 233-2503
Delaware 302 739-3032
800 464-4357
District of Columbia 202 332-2437
Florida 800 352-2437
Georgia 800 551-2728
Hawaii 800 922-1313
Idaho 800 677-2437
Illinois 800 243-2437
Indiana 800 659-7580
Iowa 800 445-2437
Kansas 800 738-2437
Kentucky 800 221-0446
Louisiana 504 568-7474
Maine 800 851-2437
Maryland 800 638-6252
Massachusetts 800 228-2714
Michigan 800 872-2437
Minnesota 800 248-2437
Mississippi 800 826-2961
Missouri 800 533-2437
Montana 800 233-6668
Nebraska 800 782-2437
Nevada 800 842-2437
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
Ohio 800 332-2437
Oklahoma 800 535-2437
Oregon 800 777-2437
Pennsylvania 800 662-6080
Puerto Rico 787 763-4575
Rhode Island 800 726-3010
South Carolina 800 322-2437
South Dakota 800 592-1861
Tennessee 800 525-2437
Texas 800 299-2437
Utah 800 537-1046
Vermont* 800 882-2437
Virginia 800 533-4148
Washington 800 272-2437
West Virginia 800 642-8244
Wisconsin 800 334-2437
Wyoming 800 327-3577

*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.