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Medicare and prescrition drugs
May 2, 2001

Two years ago it was determined that I was disabled secondary to AIDS and qualified for Social Security and my Long Term Disability policy through my former employer. My question, now that I am currently on COBRA and will soon qualify for Medicare is there any assistance to pay for my medications once on Medicare? I have asked different resources in Florida and am told that I fall between the cracks because I make over 16,000 a year. Is there any way I can get prescription drug assistance since the cost will exceed my income when you take away general expenses and I will not qualify for private insurance.

Thank You for your time.

Response from Ms. Donnelly

One of the most common medication assistance programs available for people living with HIV/AIDS who are insured under Medicare is the AIDS Drug Assistance Program (ADAP). ADAP is a state and federal program which means that both benefits and eligibility vary state to state. The AIDS Treatment and Data Network in New York has a web site that gives information on ADAP, state by state, and state Medicaid programs. You can reach them at 1-800-734-7104 or www.aidsinfonyc.org/network.

According to their website, you can make more than $16,000 and still qualify for ADAP in Florida. It is possible, depending on your income and assets, that you could be eligible for dual Medicaid and Medicare coverage as well. Medicaid covers prescription drugs. It is probably a good idea for you to consult an HIV/AIDS benefits specialist or a case manager who is knowledgeable in the area of benefits to determine what you might be qualified for.

As a program of last resort, the pharmaceutical companies run Patient Assistance Programs for drugs that have already been approved by the FDA. These programs also have eligibility criteria that involves income but generally that information is not public. These programs have their limitations, though, as many of them require your care provider to fill out paperwork and you have to reapply frequently.

If you have difficulty locating a benefits counselor or other assistance in your local area to explore your options, call the Project Inform Toll-Free Hotline at 1-800-822-7422 and ask for the Project Access Coordinator. Project Inform will assist you in connecting with someone in your local area or work with you to look at options.



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