What Every Patient Needs to Know - UMC

Pharmaceutical Company PatientAssistance Programs (PAPs)Most pharmaceutical companies provide assistancefor persons who have difficulty purchasingmedications through company-based programsknown as patient assistance programs or PAPs.Guidelines for participation can includethe following:• an application signed by the prescribingphysician• income below a certain level, set by eachcompany, usually by medication• confirmation that the applicant does not haveother coverage and that they are a U.S. citizenGuidelines are specific to each drug company,and there may be different guidelines for differentmedications. Talk to your transplant socialworker about accessing PAPs. You can find moreinformation on each drug company’s website.Links are in Section 8: Resources.TRICARE (Formerly Champus) andVeterans AdministrationGovernment funding for families of active-duty,retired, or deceased military personnel may beavailable through TRICARE. TRICARE standardmay share the cost of most organ transplantsand combinations. TRICARE also covers livingdonor kidney, liver, and lung transplants.Patients must receive pre-authorization from theTRICARE medical director and meet TRICAREselection criteria. Pre-authorization is based ona narrative summary submitted by the attendingtransplant physician.For more information about TRICARE, contactthe health benefits advisor at your nearestmilitary health care facility, call the TRICAREBenefits Service Branch at (303) 676-3526 orvisit www.tricare.mil.For more information about the VeteransAdministration (VA) National TransplantProgram, contact your VA specialist or primarycare provider. For questions about theVA National Transplant Program, call(800) 60-HEART ([800] 604-3278) or(202) 461-7130, or visit www.va.gov/transplant/.State “High Risk” Insurance PoolMany states offer a high-risk health insurancepool to provide access to coverage to individualswith serious pre-existing medical conditions.Typically the premiums are higher, and the coveragemay be more limited. Ask your transplant centersocial worker or financial coordinator if yourstate has a high-risk insurance pool or visitwww.healthinsurance.org (click on Risk Pools).Go to www.transplantliving.org (click on Beforethe Transplant>Financing a Transplant>FinancialResources Directory) for more resources.Every day holdsthe possibilityof a miracle.– Elizabeth David33