Monday, August 8, 2022

What Is The New York Prescription Assistance Program

Explore These Options To Help Save On Prescription Drug Costs

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There are a number of prescription drug assistance programs in each state of the U.S. Some of these programs, such as the Extra Help program, are designed to support Medicare beneficiaries, while some other available resources can also support state residents who are not enrolled in Medicare.

Click on your state in the map below to learn more about drug assistance programs in your area.

How To Choose A Medicare Part D Plan In New York

Consider these factors as you compare Medicare prescription drug plans available in your area:
Monthly premiumYoull pay this amount every month whether or not you use your benefits. You should have access to at least one low-cost plan in your area.
Additional costsHow much will it cost to use your benefits? Understand your deductible, copayments, and coverage during the gap and catastrophic phases.
Provider networkCheck to make sure your preferred pharmacies are in network to keep costs as low as possible.
Drug coverage/formularySee if your drugs are on the plans formulary and how much they cost each time you fill a prescription. You may want to talk with your doctor about a generic or alternative version of a drug you need.
Plan ratingsConsider the quality of the plan based on Medicare star ratings, ratings from independent organizations such as the NCQA , and reviews from plan members.

The Partnership For Prescription Assistance

The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many will get their medications free or nearly free.

The Partnership for Prescription Assistance will help you find the program thats right for you, free of charge. Remember, you will never be asked for money by a PPA Call Center representative, or on this Web site.

Visit the Partnership for Prescription Assistance website.

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How Does New York Prescription Assistance Work

New York Rx Card

The two main sources of prescription assistance are

1) pharmaceutical companies offering assistance for the drugs they manufacture and

2) government-funded insurance programs providing prescription coverage for certain vulnerable and low-income individuals and families.

In both cases, applicants must meet specific eligibility criteria to qualify for assistance.

Pharmaceutical companies usually provide assistance through a nonprofit foundation that allows patients to obtain their prescribed medications free of charge for up to 12 months before having to reapply. Government-funded health insurance may cover prescriptions at 100% or require a very small co-pay.

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Medicare Prescription Drug Plans In New York

Original Medicare offers many benefits, but it doesnt cover prescription drugs. Youll need to purchase a Medicare Part D plan to help with prescription drug costs or choose a Medicare Advantage Plan with prescription drug coverage.

New York has several options for Medicare Part D plans, some with a low monthly premium. Learn more about New York Medicare Part D prescription drug plans:

  • All New York Medicare recipients have access to a Medicare prescription drug plan in 2022.
  • There are 19 Part D prescription drug plans available in New York in 2022.
  • Seven Part D prescription drug plans in New York participate in the Part D Senior Savings Model, which offers lower out-of-pocket insulin costs than other plans.
  • The lowest 2022 Part D prescription drug plan monthly premium in New York is $7.20.

Read on to learn about enrollment, cost, and benefits of Medicare Part D plans in New York.

New York Prescription Discount Card

The program is known as the RX Card. It is free to sign up for and all state residents can get it, no matter their total household income. Thousands of pharmacies and retailers, including Wal-Mart, CVS, Walgreens, and others accept the card from shoppers. When it is used at a retailer people can save up to 75% of the cost of their prescription medications. Just present your prescription discount card when paying for your medications. It is that simple. You can dial 800.931.2297.

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New York Prescription Assistance Program

New York Prescription Assistance Program is specific to New York for prescription drug discounts. ServicesResidents can access the Rx Card online for free and bring it to their local pharmacy for discounts averaging 44% off of prescription drugs. You can also search for specific medications to get an estimate on savings on their website. The card can be accessed here: Please note that you do NOT need to enter a name or address in order to access the card it is possible to just select the mode and then click get your free card without entering personal information. How to Use ItPresent the discount card or codes to a pharmacist. Most pharmacies in New York participate in the program, including many in East Harlem like Rite Aid, Quick Rx, and Duane Reade. The pharmacy finder can be accessed here: https://newyork.prescriptionassistance.info/pharmacy-locator QualificationsAnyone in New York. There are no requirements needed to use the New York Rx Card program and they will not collect any personal information. Unlike insurance programs, there are no income, age, pre-existing condition, deductible, or waiting period restrictions. People with insurance may use the card as well for prescriptions not covered by their insurance or if the discount offers a price lower than their co-pay. You can ask your pharmacist for a price comparison.

About New York Rx Card

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  • Free For Everyone. All residents are eligible to get pharmacy discounts through this program. The program may be used to provide savings on prescriptions not covered by your health insurance or Medicare Part D. The program may also be used instead of your insurance coverage when it offers greater savings than your copay.
  • No Restrictions. There are no enrollment forms, no age or income requirements, no waiting periods, no eligibility required, no exclusions, covers pre-existing conditions, no claim forms to file, no annual or lifetime limits.
  • Lowest Price. This program has Lowest Rx Price Logic to guarantee that you get the best pricing on prescriptions . You can save up to 80% on your medications !
  • Medications. The program includes discounts on brand and generic medications, open formulary so that all medications are eligible for discounts.
  • Accepted Everywhere. The Discount Prescription Card is pre-activated and accepted at over 68,000 pharmacies around the country including most major chains.
  • Confidential. No personal information is required to get a card.

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Medicare Part D Resources In New York

Need help choosing a Part D plan or help paying for your prescription drugs? Counselors in New York can help you find the best Part D coverage for your needs. They can also help if youre having trouble getting an exception approved or have a denied claim. Get in touch with these Medicare resources in New York:

New York Medicare Resources

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior AdvisorĀ® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in The Human Touch distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote Dying Is for Pathways Hospice.

Ny Offers Free Prescription Drug Discount Card

John A. DeFrancisco

With unemployment and the cost of healthcare on the rise, New Yorkers are looking for some relief. I am pleased to inform you of a new program for lower income New York residents. The New York Prescription $aver is a FREE prescription discount card that will help save on the cost of prescription drugs.

The card, which is designed for lower income individuals who are 50 to 64 years old or persons with a disability regardless of age, can lower the cost of prescriptions by as much as 60 percent on generic drugs and 30 percent on brand name drugs. These cost savings are provided through the generous cooperation and support of local pharmacies and some pharmaceutical manufacturers.

More than 3,700 pharmacies are participating in the program, and most outpatient prescription drugs are eligible for the discount. In addition, the card is simple and easy to use. The prices of prescription drugs are reduced by a cash discount right at the pharmacy counter.

In order to be eligible for the discount card, applicants must reside in New York State and their annual income must be less than $35,000 for singles and less than $50,000 for married individuals. In addition, applicants must be between the ages of 50 and 64 or determined disabled by the Social Security Administration. Those with Medicaid coverage are not eligible.

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Elderly Pharmaceutical Insurance Coverage

This plan is New York States largest subsidy and assistance program, regardless of the beneficiaries age. Members of the EPIC Fee Plan receive help in the form of free Medicare Part D coverage, and this will save senior citizens a significant amount of money. The programs is effective because the EPIC plan will pay the monthly premiums and as well as prescription drug coverage bills for health insurance.

The program has several components. New Yorks EPIC plan, which is also the nations largest state prescription medication subsidy program, has enacted a so called wrap around plan that greatly assists those people in need. It does so as it will pay for most drug costs that are not paid by Medicare, such as coinsurance, deductibles or copayments. Other expenses may be paid too.

It pays for the gap in coverage that exists above $2,250 and it will also help pay for products as well as any needed medicines that are not covered by Medicare. Enrollees in the plan will still remain responsible for paying for state-established copayments of up to $20, deductibles, as well as additional fees up to a maximum of $1,200. Dial 1-800-332-3742 for information.

Government Prescription Assistance Programs

The Partnership for Prescription Assistance (PPA)

There are several different government prescription assistance programs available, each with its own set of eligibility requirements. Some programs are available to all Americans, while others are only available to people who live in specific states or who meet certain income requirements. The most common government prescription assistance programs are:

  • the Medicare Part D prescription drug coverage program
  • the Medicaid prescription drug coverage program
  • the Veterans Affairs prescription drug coverage program

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How To Apply For Prescription Assistance Programs

To apply for a prescription assistance program, you will need to provide some information about yourself and your prescription medications. This information will usually include:

  • your name, address, and contact information
  • information about your prescription medications, including the name of the medication, the dosage, and how often you take it
  • proof of income
  • Once you have gathered this information, you can apply for prescription assistance programs in several ways:
  • online: many prescription assistance programs have online applications that you can complete
  • over the phone: some prescription assistance programs have toll-free numbers that you can call to apply
  • in person: you can also visit a local social service or community health center to apply for prescription assistance programs

Pharmaceutical Company Prescription Assistance Programs

These prescription assistance programs are offered by pharmaceutical companies to help people who cannot afford their brand-name medications. The eligibility requirements and the medications that are covered vary from program to program, so you will need to check the specifics of each program. However, most of these programs require that you have no prescription insurance coverage and meet certain income requirements.

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How To Get Prescription Assistance

To start the ball rolling, apply today for Simplefill membership, either online or by calling us at 386-0206. The only other thing youll need to do is answer some questions about your prescription needs, financial circumstances, and insurance status.

Well handle the rest:

  • Well use the information you provided to create your Simplefill member profile.
  • Then well compare your profile to available prescription assistance programs and identify the best ones for you.
  • Well prepare applications and submit them on your behalf.
  • And when youre accepted, well get you enrolled.

Longer term, well make sure your prescription is always current so that youre never without the medication you need. If there are changes to your treatment regimen, well update your profile and connect you with prescription assistance for any new medications added by your health care team.

Our goal is to make you wonder how you ever got along without us!

What Prescription Assistance Is Available In New York

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For people living with chronic diseases , the high cost of prescriptions in the U.S. can be a crushing burden. Fortunately, prescription assistance is available from pharmaceutical companies and government-sponsored insurance programs.

The New York Drug Card is available free of charge to all New York residents. You can download one and put it to use right away to receive drug discounts of up to 80% on your prescriptions at pharmacies statewide.

The New York Department of Health administers New York Medicaid. Funded by state and federal dollars, Medicaid provides several insurance options for vulnerable and low-income New York residents. Those options include a variety of managed care plans, Childrens Medicaid, and Child Health Plus, which is for uninsured children from low-income families who dont qualify for Medicaid.

The New York AIDS Drug Assistance Program provides free or very low cost AIDS-related medications to eligible uninsured and underinsured New Yorkers living with HIV/AIDS.

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Medicare Part D Plan Eligibility And Enrollment

You can enroll in a Medicare Part D prescription drug plan if youre enrolled in Medicare Part A and/or Part B, or a Medicare Advantage Private Fee-for-Service Plan that doesnt offer prescription drug coverage. You must be enrolled in Medicare Part A and B to join a Medicare Advantage Plan.

It pays to enroll in prescription drug coverage during your initial enrollment period, even if you dont take prescription medications. If you dont enroll during this period and have no creditable drug coverage, youll have a 1% penalty for each month you dont enroll, which will be added to your Part D monthly premium.

Part D enrollment is available during specific enrollment periods:

Medicare Part D Enrollment Periods
Enrollment period
Enroll in a new plan, disenroll, or make a one-time switch from one plan to another.
Medicare Advantage Open EnrollmentSwitch to a different Medicare Advantage Plan with or without drug coverage. Go back to Original Medicare and enroll in a Part D plan.

There are multiple ways to enroll in Medicare Part D prescription drug plans:

When you join a Medicare drug plan, youll give your Medicare Number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.

Manufacturer Copay Assistance Programs For Prescription Drugs

Manufacturer copay assistance programs are intended to help commercially insured individuals afford the cost of expensive prescription drugs, by covering a portion or all of the deductible and copay for some medications. This financial assistance is offered to eligible individuals who meet certain criteria set by the manufacturer.

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What Medicare Part D Costs In New York

Youll pay a monthly premium and be subject to an annual deductible and copays for each prescription with a Medicare Part D plan.

  • Lowest Part D monthly premium in New York: $7.20
  • Maximum annual deductible: $480

$3.95 copay or 5%

Brand-name drugs:

$9.85 copay or 5%

The initial coverage phase starts when you meet your deductible and ends when you and your plan have spent $4,430. You then enter into the coverage gap phase until your out-of-pocket spending reaches $7,050. You pay a small amount for prescription drugs for the remainder of the year while you are in the catastrophic coverage phase.

If you have limited resources, you may be able to get financial assistance through Medicaid, Extra Help, or Pharmaceutical Assistance Programs in your state.

Epic Has Two Tiers Of Coverage

New York Rx Card

1) “Fee” program.

Income eligibiilty threshold: $20,000 yearly/singles, $26,000/couples.

Members are charged an annual fee on a sliding scale basis. Fee ranges from $8 to 300 and is waived for full “Extra Help” recipients.

SEE CHART OF Fee Scale

2) “Deductible” program:

Income eligibility threshold: $20,001-$75,000 yearly $26,001-$100,000 yearly .

No fee charged, but EPIC coverage doesn’t kick in until/unless member’s out of pocket Part D drug costs meet a specified limit . The amount of the deductible ranges from $530 to $1,715, based on the household income.

See Chart of Deductibles by Income.

Some EPIC members have plans which charge an annual Part D deductible. EPIC cannot cover the cost of the Part D deductible.

Where to get more information

Call the EPIC helpline at 1-800-332-3742 or visit EPIC’s website. Copies of the EPIC statute and regulations, are attached to this article.

Click HERE to access application and more information on EPIC.

Attached files

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