Free Medicine for People Who Cannot Afford It

There are a number of places you can get medications if you do not have any funds. Some of these sources work well; some not so well. If the problem is critical enough for you, you should try every source with each of your medications.

Before you start, it is a good idea to make a list of each medicine you take and the dosage. Then call your pharmacist and find out who makes each medicine.

While some of these suggestions are obviously good, others are controversial. We name them all, controversial or not, in an effort to be as helpful as possible with this problem which is so vital for some people. Use those portions of the list at your own risk! Do not take any step listed below without your doctor's approval!

If you discover another source of free medicine, please call me and let me know, so we can help others. Paul McChesney at 1-800-775-3985 or on the web at www.carolina-disability.com.

The suggestions:

A. Getting near 100% of the expense paid. Be sure to try each one of these that might work:

1. Health Insurance That Covers Medication. This is almost always the best way to get medicines paid for. If you have any potential access to health insurance and you have health problems, you probably need to buy it, and do whatever you have to keep it up. If you have health problems and drop coverage, there is a good chance that you will never again be able to get private health insurance. Don't drop coverage thinking you can pick it up again later unless you are sure. Don't drop this thinking you will get medicine in any other way. If you have insurance, you will usually get your medicine paid for. If you don't, it is possible that none of the other things listed here will work.

• With many companies, if you qualify for Long Term Disability benefits, you also get health insurance.
• With others, as long as you are formally on the payroll, you can keep your insurance.
• Some people can get on their spouse's insurance.
• Some companies will enroll a "significant other," even if there is no formal marriage.
• Sometimes there is a waiting period during which pre-existing diseases are excluded; if so it is often worth it to buy the insurance and pay until the waiting period is over. Some other companies have "open enrollment" periods during which anyone can enroll.
• There is a Federal law called "COBRA" that requires employers to offer health insurance to individuals who are terminated from group coverage under most circumstances. The period during which you can get insurance varies depending on why you were terminated. For most people, the period is 18 months, which is extended to 29 months if you are found to be disabled by the Administration before the 18 months is up, and if you let the insurance carrier know that. Be aware that if you miss one monthly payment, your insurer might be able to cancel.
• Some states have insurance for the uninsurable; go to the following: http://www.healthinsurance.org/riskpoolinfo.html for a list of good websites.
• Ways to get and keep insurance, including Medicaid, are set out at http://www.healthinsuranceinfo.net/sc00.html for South Carolina, http://www.healthinsuranceinfo.net/nc00.html for North Carolina, and http://www.healthinsuranceinfo.net for other states.

2. Medicaid. Apply at DSS if you think that you might qualify, or even if you think you don't. There are many different ways to qualify. If you live in North Carolina, Medicaid never looks at your Social Security application. If you live in South Carolina, it does, sometimes, and will therefore deny you until you win your Social Security case.

3. The Veterans' Administration, or VA, provides free prescriptions for some low income veterans who have been honorably discharged from the military. Some veterans may obtain prescriptions for $7. Veterans must enroll with the VA, be seen by a VA doctor and receive the prescriptions from VA hospitals and pharmacies. Contact the VA at 877-222- VETS (877-222-8387) or http://www.va.gov for information.

4. Manufacturer's Free Drug Programs. There are over 1,400 drugs that are made by 100 manufacturers who have free drug programs. Most major drug companies provide free medications, but rarely, if ever publicize their programs. An estimated two billion dollars of free medication is given away annually. The Needymeds website keeps up with all of these programs. If you can use the Internet well, visit their website at http://www.needymeds.com.

5. State Assistance Programs. Call your state government or maybe Social Services. Communicare, for example, in South Carolina. Call 1-800-763-0059. Communicare only pays for one medicine, but pays the entire cost of it.

6. Local Free Clinics. If you can get into a local free clinic, it will often have a system for getting your medicines for free. Call your local United Way for a list of such clinics.

It often takes persistence to get into a free clinic. Don't give up and keep trying different things. For example, for Spartanburg's Center for Family Medicine, you might have to keep calling; you will call a hundred times and they will not be taking new patients, and then finally they will be. Once you get in, you will get a green card that lasts 6 months. As that is about to expire, they have a form that your doctor can fill out, saying you are disabled. If you get him to sign that, they will treat you for another 6 months, and you can keep doing that.

7. Pharmacy Discount Cards. Some of these are such good deals that the drugs are almost free. Of course they only work for medicines that are manufactured by the card issuer. The ones like this that I know about are as follows:

• Eli Lilly's Lilly Answers Card (877) 795-4559 Covers all Lilly's drugs except controlled substances. Must have an annual income below $18,000 per individual or $24,000 per couple. $12 Co-pay per prescription for 30-day supply.
• Novartis' Care Card (866) 974-2273 Covers select Novartis drugs. Tier 1 must have an annual income below $18,000 per individual or $24,000 per couple. $12 Co-pay per prescription for 30-day supply. Tier 2 must have an annual income below $26,000 per individual or $35,000 per couple. Receive a 25% or more discount.
• Pfizer's Share Card (800) 717-6005 Covers all Pfizer's drugs. Must have an annual income below $18,000 per individual or $24,000 per couple. $15 Co-pay per prescription for 30-day supply.

8. Get Sponsored by Vocational Rehabilitation. This only works if they take you on as a client, which they will do only if you convince them that you really want to work, and if they help you a little, you probably will.

9. Get Your Doctor to Give You Free Samples. This only works if you can somehow get in to see a doctor, and if you can get him or his staff to like you. Work hard on both of those things. This is pretty uncertain, so if you are getting medicines in this way, you should work on other ways, too. Some doctors have lots of samples, some only a few.

B. Saving Money on Medicines. These methods will not usually pay for all of your drug expenses, but will often save you a lot of money.

10. Buy Medicine by Mail Order from Canada to Save as Much as 75%. You can get many drugs at a discount by ordering from Canada. Because of the patent, manufacturers of most new drugs have a monopoly, meaning that there is only one seller. In the US, that seller is allowed to charge whatever he wants to, but in Canada, the government regulates the amount the seller is allowed to charge. There is some concern about the legality of buying drugs from Canada, and there have been some concerns raised about the quality of these drugs, and about the quality of drugs purchased on the Internet. I take no position on any of these questions, and only advise you that these websites exist, and that they are one potential step you might consider. Canadian mail order pharmacies include http://www.canadameds.com, at 877 542-3330; http://www.thecanadiandrugstore.com, at 888 372-2252; http://www.crossborderpharmacy.com, at 888 626-0696 and http://www.canadadrugs.com, at 800 CAN-DRUG, or 800 226-3784.

If you live close to the Mexican or Canadian border, you can consider driving to either of these countries to get your prescription filled. If you are uncomfortable in ordering medicine from Canada, there are mail order firms in the US that are usually less expensive than local pharmacists. Start by trying at http://www.drx.com/rxaminer/company/vendors.asp for the prices at about 10 of the most respected US sites.

11. Drug Discount Cards. These are not as good as the cards listed above, but will sometimes save you money:

• AdvanceRx offers a free discount card to anyone any age that saves 13%-25% and covers all drugs dispensed at a pharmacy. For details, call 1-800-ADVANCE (238-2623). There are five free discount cards for Senior citizens. They cover over 200 common medications. Savings on average 20-40%
• Glaxo-Smith-Kline's Orange Card (888) 672-6436 Covers all GSK.s drugs. Must have an annual income below $30,000 per individual or $40,000 per couple 30% average savings at participating pharmacies
• The Together Rx Card (800) 865-7211 Over 150 select drugs from a group of manufacturers. Must have an annual income below $28,000 per individual or $38,000 per couple. (Higher in AK and HI).

12. Save Up to 93% by Asking for a Generic. Some doctors claim there is a difference, and perhaps there is, but some say that this claim in the mind of a few doctors results from the billions of dollars that brand name companies spend every year to brainwash them. The amount drug companies spend to do this is startling; drug companies as a whole spend about $10,000 per year per doctor on everything from free pens to free vacations for doctors; this is more than they spend on research to develop the drugs, and more than they spend to manufacture them. If the money does not influence doctors' opinions, why would the drug companies be spending it? The Federal Government says that both brand name and generic drugs contain the same active ingredients, are the same in strength and dosage, and meet the same government quality control standards. Here are some examples:

• Prozac brand 20mg, 100 tablets cost $280.19 and generic sells for $29.99 (Savings 89%)
• Vasotec brand 5mg, 100 tablets costs $103.59 and generic sells for $18.19 (Savings 82%)
• Zantac brand 150mg 100 tablets costs $173.39 and generic sells for $10.99 (Savings 93%)
• Zestril brand 10mg 100 tablets costs $96.29 and generic sells for $39.99 (Savings 58%)

13. Ask for an Older or Different Medication That Is As Effective or Nearly As Effective. The drug companies spend billions persuading doctors to prescribe, and patients to buy, drugs for which they still have a patent, since they can get a monopoly profit off of them. Often there is an older drug that works just as well or almost as well. Even more often the older drug works better than nothing, if that is all you could otherwise afford. Doctors often select the expensive patent drug only because they assume you can afford it. There also might be other medicines that are not older, but are simply different, but with very similar effects. You might be able to get more help with the different medicine than you are with the medicine that you are now taking. To try this tack, get a list from your doctor of all of the medicines that would be equivalent to the one you are now taking. Try all of the steps listed on this entire list for the alternate medicine.

14. Over-the-Counter Drugs May be as Effective as the Prescription Drug. For example, many doctors still prescribe Pepcid 20mg to their patients. A one-month supply of Pepcid 20 mg cost approximately $60. Pepcid AC, over-the-counter in 10 mg strength, taking double the dose costs approximately $23. Most prescription cold medications average $20 to $60 for a one month supply and contain the same decongestant that is available over-the-counter for less than $2.

15. There Is a Superb Website, http://www.rxaminer.com, That Names Alternate Medicines That Are about the Same as What Your Are Taking, but less Expensive. If you are thinking about adjusting your medications, be sure to visit this superb site! You input what drugs you are taking, and it suggests other medications that the web authors think would be about the same, and gives prices and online purchasing options at a few online vendors. But note that they will not list the Canadian websites; once you get the proposed substitute, if you feel comfortable in doing so, check the Canadian sites listed in number 10, above. And of course take what they say as a suggestion to be approved by your doctor!

16. Use a Pill Splitter. Most pharmacies stock pill splitters. Sometimes, medications can be broken in half and save you 50%. The reason is because several pharmaceutical manufacturers price some of their medications the same for all strengths. Cost savings is more typically 32 to 50%. Get your doctor's permission before doing this! The effect of some drugs is changed drastically, sometimes dangerously, if split! Do NOT split timed-release medication, particularly narcotics!!! On the other hand, the effect of most is not changed at all.

For example, Lipitor is essentially the same price for all strengths. It is possible to save as much as $100 on a one month supply of Lipitor just by getting the larger strength and cutting in half, if your doctor approves.

To do this, begin by asking your doctor or pharmacist if your medication is available in a dose double your normal dosage (e.g., if you usually take a 20 mg. pill, is a 40 mg. pill available?). If it is, ask whether there would be any problems with splitting the tablets or capsules. Next, do a cost comparison between the two dosages. If the higher dose is less than double the cost for your regular dose then you will be saving money by having your doctor prescribe the higher dose and then splitting it. Finally, get your doctor's approval for splitting the pill.

17. Save by Buying a 90 vs. 30-Day Supply. Most pharmacies have higher savings on a longer days supply. In addition, when it comes to people who have insurance prescription coverage, there may be other savings by getting a larger day supply. Sometimes it pays to do this even if you have to waive insurance reimbursement. For example, assume that you have a $10 insurance co-payment, but the insurance company only lets you get a 30 days supply for that $10. A 90-day supply bought without insurance might only cost you $18. This would be cheaper than paying $10 per month ($30 for 90 days).

18. Get Only a 7-day Supply of New Medication. If the doctor does not have samples, ask your pharmacist to give you only a one-week supply to try. Medicines can't be returned once they are dispensed. If you get a month's supply and can't tolerate the medicine, you have lost that money.

18. Stop Using Drugs You No Longer Need, or Never Needed, or Are Doing You No Good. Sit down and have a heart to heart talk with the wisest doctor you can find, and perhaps a pharmacist, about whether you really need all of the medicine that you are taking. If their answers don't make sense, perhaps talk to another doctor. Explain your financial circumstances. Start with the drugs that seem to you to be doing no good. Some drugs will help some people and will not help others at all. Some drugs are very expensive, but help only a little, and the benefit is not worth the cost or side effects. Some only treat symptoms, and, if you can tolerate the symptom, you can do without the drug without any health impairment, and can thus avoid the expense and side effects of the drug. But be aware that there are some drugs that seem to do no good, but are actually crucial to the health of certain people! Never make the decision to stop a drug without a doctor's advice! For example, high blood pressure can cause no symptoms, but in fact be life-threatening; the medication to control it might make you feel no different, or even worse, but can in fact be life saving. Some doctors believe in prescribing lots of drugs; some doctors think that fewer is better. Who is right in your case is one of those difficult questions that you must decide on your own, after listening carefully to each sort of doctor.

19. Consider a Drug Holiday for Certain Drugs. Before you read this section or take any action under it, you must be aware that there are many drugs for which you should most certainly NOT take a drug holiday. For some drugs, taking a holiday is unwise or even dangerous. Consult your doctor to find out which drugs might be a candidate for a drug holiday. Most doctors say that use of certain drugs causes you to develop a tolerance, meaning their effectiveness at a given dose decreases over time. This is not true of all drugs. Some doctors will say that this is true of some, but not all pain drugs, particularly narcotics. Some, but not all doctors say that, if you can reduce your use of such drugs for a period, they are more effective if you have to use them later. You must do this under a doctor's close supervision and only with his or her approval. The alternatives are either to keep taking more and more of the drug, which can become expensive and dangerous, or to continue a level dose. At a level dose, over a long period, your pain perception is sometimes not all that much less than it would be if you were not taking the drug. The increased pain you feel when you miss a dose is to a certain extent from the withdrawal process, rather than from the underlying problem. It is nevertheless quite significant pain. A reduction in dosage of these drugs is often not easy, can be dangerous, and should not be done except under the direction, under the close supervision, and with the approval of a doctor! While some doctors don't worry about potentially addictive drugs at all, others say that taking them for chronic conditions is dangerous. Most say that suddenly stopping them once started is dangerous. This is why a prescription is required for them, and why they should begun only if absolutely necessary, and then be taken only under the close medical supervision of not just any doctor, but a wise one. Everything said in this paragraph is highly controversial, and should not be taken as true, but only as a suggestion for consultation with a wise doctor. You can find doctors who feel strongly that narcotics are acceptable for, say, fibromyalgia, and others who feel strongly that they should not be prescribed for such conditions.

20. Consider Taking Less of Certain Drugs. The drugs to consider taking less of are those described in 18 and 19, above. Again, do not try this without the advice and consent of a wise doctor!

21. Be Sure That You Are Not Taking Two Drugs That Have the Same, or Nearly the Same, Effect. It is surprising how often this happens, especially when you have been to a number of doctors, or tried a number of drugs to treat your condition. Sometimes a higher dosage of one drug will be as effective as one lower dosage of two related drugs. Again, consult with your doctor before eliminating one of the drugs.

22. Buy Home Test Kits. Kits for testing for colo-rectal cancer, blood sugar, cholesterol, HD, cholesterol, triglyceride, and many other conditions can be purchased as home tests instead of paying twice as much for similar kits at your doctor's office. But you will still need to get a doctor to explain the meaning of most of these test results, and you and your doctor together must decide whether the results are as accurate as those you get in a doctor's office.

23. AARP Members are Eligible for Many Discounts, Including Mail-Order Pharmacy Discounts. You may find out more information at http://www.aarp.org

Some of these suggestions were taken, with permission, from http://www.institutedc.org, which offers some further useful suggestions on its website and in a book they offer for sale on the site. The balance is © Paul McChesney, but may be reproduced on the web on the condition that a link back to http://www.carolina-disability.com. To find out how to link to us, click here.