Health Care : Prescriptions
What if I an uninsured and need prescription medications?
There are several programs that help uninsured people afford their medications.
First, ask your doctor if she can give you free samples of your prescription medications. Many doctor offices get free samples of medications, so they may be able to give them to you.
Second, the Ohio Best Rx program offers discounts on prescription drug costs for many Ohioans without prescription drug insurance coverage who are:
60 years of age or over; OR
under age 60 with annual family incomes of less than 300% of the Federal Poverty Level which is: $30,636 (single), $41,076 (family of two), $61,956 (family of four).
Third, many prescription drug manufacturers have patient assistance programs that may offer your medications for free or for a reduced fee. Visit the Pharmaceutical Research and Manufacturers of America website or theRxAssist websiteto see if the medications you take are included.
On February 1, 2010, Ohio Medicaid will change the way it provides prescription drugs and some medical supplies to some clients.
Ohio will "carve out" these services from the managed care providers and, instead, provide these services through its fee-for-service system.
The carve-out will affect roughly 1.5 million people enrolled in Medicaid managed care. This change may cause some Medicaid clients more difficulties in accessing their prescriptions or medical supplies.
Some of the problems we anticipate seeing are listed below.
(1) Finding a pharmacy that accepts Medicaid
Currently, many recipients in managed care obtain their prescriptions through pharmacies that do not accept Ohio Medicaid. Under the carve-out they will have to find a pharmacy that accepts Ohio Medicaid. This may be difficult for some people who live in rural areas and will be more difficult for people when they are out-of-state.
(2) Paying Co-payments
Currently, most adults in managed care do not have co-payments for prescription drugs. Under the carve-out adults may have co-payments of $2 or $3 for prescription drugs. For those people with many prescriptions to fill each month, these co-payments can quickly add up.
(3) Adding Newborns to Cases
Currently, newborns have immediate access prescription coverage through their mothers' managed care plan. But, under the carve-out they may not have access until their county caseworker add them to their mothers' Medicaid case, which may take weeks or months. In the meantime, parents may have difficulty getting prescriptions filled for their child.
(4) Prior Approved Prescriptions
Currently, many patients are receiving prescription drugs that their managed care plans have prior authorized. But under the carve-out their doctors will have to obtain prior authorization through the state system.
What if I have problems with the new Medicaid prescription drug program?
If you need assistance getting your medication or you experience any problems, please contact Chris Barley, firstname.lastname@example.org, at the Ohio Poverty Law Center. When you contact Chris, please include your contact information including name, address, phone number and email, along with a short description of your problem and when would be a good time to reach you.
See also the Forms & Education tab in this section for more information.
The information in this site is not intended as legal advice.
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