Keep in mind that you may have choices of different Medicare Part D plans. During open enrollment, you can evaluate which plan might be the most affordable, comparing drug copays and deductibles to find the plan that keeps your specific costs the lowest. The Medicare Plan Finder Tool allows you to enter your exact medications and compare coverage for them under different Part D plans.
Also note that Medicare has a maximum out-of-pocket cap of $2,100 for Part D plans.
Exploring Financial Assistance Programs
Another option for making COPD medications more affordable includes financial assistance and discount programs, which can vary from nonprofit organizations to manufacturer savings programs. Some states and local senior centers offer an ombudsman or other aide to find programs like these and complete an application.
Government Support
Charitable Copay Grants
Even if no patient assistance grants are available based on your specific situation and needs, the finder lets you enter your information and be notified as soon as a new opportunity becomes available, says Courtney.
Manufacturer Savings Programs
Many pharmaceutical companies have programs for when your health insurance policy doesn’t cover the cost of your medication. Eligible individuals typically include those with a commercial insurance policy, Medicare, Medicaid, or no insurance at all.
Known as savings programs, copay cards, patient assistance programs, or coupons, manufacturer programs generally have eligibility requirements based on insurance status, income, and the specific medication. Those who qualify get a coupon or other paperwork to take to their pharmacy. After your health insurance pays its portion of the medication’s cost (if any), the program pays part or all of the remaining copay or coinsurance. Pharmaceutical companies typically place a monthly or annual cap on how much they will cover each year. Once you reach that cost, you’ll be responsible for the remaining amount.
Pharmacy Savings Programs
- SingleCare This discount card can be used by anyone, regardless of financial need or insurance coverage. This organization partners with pharmacies nationwide to negotiate discounts on certain prescriptions.
- Medicine Assistance Tool This search engine, launched by the Pharmaceutical Research and Manufacturers of America, focuses on patient assistance resources.
- NeedyMeds A national nonprofit, NeedyMeds maintains a website listing prescription assistance programs and has a telephone help line.
- RxAssist Run by pharmaceutical companies, this online resource center has a comprehensive directory of patient assistance programs.
Doing this type of research can sometimes feel overwhelming, says Courtney. But talking with your healthcare provider’s office may help you select an option that fits your needs, since many healthcare providers offer financial navigator services.
Importance of Making the Effort
In general, it’s worth the time and effort to research options that make COPD medications more affordable, according to Courtney.
“Although there's no cure for COPD, proper management that includes medication adherence can reduce symptoms and improve quality of life,” he says. “Another advantage is that many of these medications have been shown to reduce the risk for exacerbations, keeping patients out of the emergency room or hospital.”
The Takeaway
- Medication adherence is a crucial part of managing COPD effectively, but the cost of treatment may be prohibitive for seniors who are on a fixed income.
- The first step in learning about financial assistance and insurance coverage is a conversation with your health provider, who may be able to help you navigate your options.
- There are many financial assistance programs available, including pharmacy savings programs and reduced copays from pharmaceutical companies.
Resources We Trust
- Mayo Clinic: COPD
- Cleveland Clinic: Chronic Obstructive Pulmonary Disease
- American Lung Association: What Should I Do if I Can't Afford My Medications?
- Patient Advocate Foundation: FundFinder
- NeedyMeds: Healthcare Savings
