Managing a chronic disease, such as rheumatoid arthritis, can be made more difficult if you are unable to afford your medications or health insurance premiums.
Copay assistance programs help patients who cannot afford to pay for prescribed medications despite insurance coverage. Frequently, drug manufacturers are able to provide financial help directly which should be your first resource to explore. To access manufacturer-sponsored programs, visit the brand website for the RA drug which you have been prescribed.
For patients who do not quality for manufacturer programs (perhaps due to insurance coverage through government programs such as Medicare), the following non-profit organizations offer additional help paying for medications. Some of these programs even offer financial help with insurance premiums and transportation costs to obtain treatment.
In general, to participate in these programs, the patient must have valid medical insurance that covers the prescribed medication, which in turn must be included on the program formulary; and the patient must meet annual household income criteria established by each program. One program included below offers help with generic medications regardless of insurance coverage.
- Good Days, formerly known as the Chronic Disease Fund, provides direct financial assistance to RA patients prescribed one of the following biologic drugs: Cimzia, Humira, or Remicade. To participate with Good Days, patients must remain fully compliant with their medication.
- Good Days offers a Premium Assistance Program that helps patients find, and pay for, appropriate health insurance coverage.
- The Good Days Travel Concierge Program offers transportation services for pre-approved medical appointments to obtain treatment. If needed, the program may also arrange and cover lodging. Additional travel expenses, such as parking, fuel and meals, are covered.
- The Assistance Fund Copay Assistance Program offers financial support to individuals with RA who need help paying for their out-of-pocket expense for approved specialty medications covered by insurance. Ten biologic and disease-modifying anti-rheumatic drugs (DMARDs) for RA are included in the copay program.
- The Assistance Fund Health Insurance Premium Assistance Program offers financial assistance to individuals who need help paying for their monthly health insurance premiums.
- Patients are able to receive assistance through both programs simultaneously, as long as funding is available.
- The Patient Access Network Foundation offers financial support to individuals with RA, covered by Medicare, who need help paying for out-of-pocket costs related to ten FDA-approved disease-modifying therapies. Patient household income must fall below 400% of the Federal Poverty Level. Maximum award is $3800; however, enrolled participants may apply for a second grant during their eligibility period if funding is available.
- Rx Outreach is a nonprofit mail-order pharmacy in St. Louis, Missouri, that offers generic medications at a reduced price to low-income patients. More than 600 medication strengths that cover most chronic diseases, including rheumatoid arthritis, are available. Patients can be on Medicare, Medicaid or other health insurance and still receive medications through RX Outreach. To be eligible, the family’s income must fall below 300% of the Federal Poverty Level. Most prescriptions are filled in 90- or 180-day supplies.
- Caring Voices Coalition (CVC) offers non-financial assistance to individuals with RA. CVC insurance specialists can assist with denied claims appeals and help patients resolve insurance issues and explore sources of new or improved insurance coverage.
- The CVC Social Security disability program supports patients through the various stages of the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) application process. Patient advocates, including skilled attorneys, coordinate supporting evidence, assess eligibility, submit claims for benefits and draft arguments.
- CVC’s patient education program helps to connect patients with public and private services that provide physical and emotional support to make life easier.
- The Patient Advocate Foundation (PAN) does not offer a designated copay assistance fund for individuals diagnosed with rheumatoid arthritis. PAN does offer vast mounts of information related to insurance and other financial matters. PAN case managers can assist patients in identifying other programs available within their state or locale that may be able to help.
Programs may periodically be unable to accept new or renewal applications based on lack of available funding. If you encounter a program which is temporarily closed to applications, try contacting the program again at a later date.