I work for a company in Texas who is self-insured, and we have a cap of 2,500 for medications per year. What can I do once that cap runs out? I make too much to qualify for any state assitance programs, and I make too little to manage any meds on my own. I make 40.5K a year. I feel like one of those lost in the middle with no options. What can I do?

You are actually in a difficult situation. I am assuming that you live in Texas as well as work for a company there. There are some options available to you in a couple of other states, but I am unaware of options for state assistance in Texas at your income level. If I am making an incorrect assumption as to your residence, your options may be different. There are also sometimes some Title I (or large urban areas impacted by HIV) programs to help people who can't get medication. Again, your income may be too high but it is worth checking with your local AIDS service organization.

There is some chance that you could be eligible for a pharmaceutical assistance program. These are programs run by individual drug companies. The programs also have income limitations that generally seem lower than your income, but the companies don't publish their criteria so it is always worth investigating. The programs do have drawbacks in that they require you to apply to each company that makes a drug you need seperately. Your doctor has to be involved with the paper work and, generally, you have to re-apply fairly frequently.

Usually the best way to review your options is to find a benefits counselor or a treatment advocate in your local area. However, if you have difficulty finding such a person, you can call the Project Inform hotline and ask for the Access Coordinator. The number is 1-800-822-7422.