Consumer Alert Highlights Dangers of "Patient Assistance Programs"

Are "patient assistance programs" a scam?

For Medicare members, especially in the coverage gap, looking to patient assistance programs for financial support can be helpful. If you can’t afford the prescription drugs you need, you may be eligible for assistance programs. Manufacturer-sponsored patient assistance programs are nonprofit organizations where medications come directly from the manufacturer without billing you or your insurance company.

Qualifications are based on your annual income, out-of-pocket prescription expenses incurred and other manufacturer-specific requirements. The application process is free. Then, if you qualify, your prescription medication and refills are free. If you are struggling to afford much-needed prescription medication(s), manufacturer-sponsored patient assistance programs can make an expensive medication available.

Don't be fooled 

Recently, potentially misleading “patient advocacy groups” are claiming to help people apply for patient assistance programs. These third-party “advocacy groups” charge money for helping people complete the manufacturer-sponsored patient assistance application and getting manufacturer-sponsored prescription refills. When people search for manufacturer-sponsored patient assistance programs online, these “advocacy groups” use pop-up messages and websites for their product. Many times, they are a top result on search engines like Google or Bing.

Our pharmacy team investigated third-party “advocacy groups,” and learned that many different companies charge for application, medication and refill services. They found those applying unknowingly paid this fee because they were unaware that they could go directly to the manufacturer website and complete the application free of charge.  Again, valid manufacturer-sponsored patient assistance programs are free.

How to know who to trust with patient assistance programs

A trusted source for manufacturer-sponsored patient assistance programs, as referenced by WebMD, is https://www.rxassist.org/patients. To get started, simply type your medication in the search term box, hit submit and click on the medication name. The next screen contains everything you need to participate in the free manufacturer-sponsored patient assistance program. This includes the application to download, manufacturer website, manufacturer contact information, eligibility information, application requirements and how the medication is sent. Again, whether or not you qualify, there is no charge for medications or refills and in most cases, shipping is free.

If you are concerned that you may have been scammed or you want to be sure you are getting access to free information on assistance programs, call our Incident Hotline at 877-700-7020 or click Report an Incident at https://nh-hcc.com/. Reports can be made anonymously 24 hours a day, seven days a week.