Medicare and Medicaid Programs
Learn more about state-based consumer assistance programs that help people on Medicare and Medicaid get the best coverage.
Many states offer help to consumers with health insurance problems.
State Health Insurance Assistance Program (SHIP)
Contact your local SHIP for in depth, one-on-one insurance counseling and assistance with Medicare.
Medicare Savings Programs
State-based programs help people with limited income pay Medicare premiums, and may pay Medicare deductibles and coinsurance.
PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet health care needs int he community.
Medicare Extra Help
Extra Help is a government program that helps people with limited income pay Medicare prescription drug program costs, such as premiums, deductibles and co-insurance. Apply through the Social Security Administration.
Some people qualify for both Medicare and Medicaid, called dual eligibility. Access your state’s Medicaid website to learn more.
Medicare Rights Center
This private organization helps people in need who are on Medicare find financial assistance through such programs as Medicare Part D Extra Help, a federal program that helps pay Medicare prescription drug costs. There is also an interactive tool to guide people to the best Medicare assistance program.
State Pharmaceutical Assistance Programs (SPAPs)
Most states have prescription financial assistance programs for low-income residents. Each has its own eligibility requirements, and program names vary by state. Many require enrollment in the Medicare prescription drug benefit (Part D) and application for Medicare Extra Help. SPAPs generally pay or help pay Medicare drug premiums and cost-sharing, as well as costs in the coverage gap, sometimes only for certain diagnoses. Some may also pay for drugs that are excluded from Medicare drug coverage or are not included in your Medicare drug plan’s formulary.
Private Programs and Resources
Patient Access Network Foundation
This foundation provides annual allocations to help cover out-of-pocket costs related to prescriptions (co-payment, deductible or co-insurance) for low-income patients with specific diagnoses. Maximum annual allocations vary by diagnosis (ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis: $3,800/year; uveitis: $1,500/year). Patient must be on Medicare, and Medicare must cover the medication for which assistance is needed.
General Prescription Assistance
The Assistance Fund
This program offers multiple levels of financial assistance for prescription expenses. Assistance is allocated according to diagnosis. Check to see if your diagnosis is currently covered. If not, check back periodically see if it’s been added.
Benefits Check Up
This service of the National Council on Aging helps people find government and private programs to help pay for prescriptions and other health and daily living needs.
Good Days from CDF
This organization funds medication co-pay assistance for those who cannot afford their medication. Requires proof of income; offers one-day approval. Assistance is allocated according to diagnosis. Check to see if your diagnosis is currently covered. If not, check back periodically to see if it’s been added.
The HealthWell Foundation
Out-of-pocket prescription cost assistance provided to covered diagnosis. Assistance is allocated according to diagnosis.
A comprehensive source of information on assistance programs available for people having difficulties paying for their medications or health care. Assistance is allocated according to diagnosis. Check to see if your diagnosis is currently covered. If not, check back periodically see if it’s been added. Diseases covered lupus, AS, arthritis, fibro, PsA; sign up for email alerts to learn when new diagnosis-based programs become available.
Patient Advocate Foundation
This foundation’s Co-pay Relief program provides assistance with out-of-pocket medication expenses to those who are eligible. Its Patient Services Program provides arbitration, mediation and negotiation to settle issues about access to care, medical debt, and job retention related to their illness. Assistance is allocated according to diagnosis. Check to see if your diagnosis is currently covered. If not, check back periodically see if it’s been added. No arthritis diseases currently listed.
Partnership for Prescription Assistance
A clearinghouse funded by biopharmaceutical research companies that provides access to 475 industry and private organizations that help pay for more than 2,500 generic and brand-name medications. It includes more than 40 programs that focus on children.
A fully-licensed mail order pharmacy that provides more than 500 brand-name and generic prescription medicines at reduced cost to low-income, uninsured and underinsured individuals and families, as well as those who have limited insurance coverage for prescription drugs.
Cost Plus Pharmacy
Low-cost pharmacy, but does not accept insurance payments.
Operation Walk USA
Operation Walk USA is an independent medical humanitarian organization that provides free hip or knee replacement surgeries at participating sites in more than 20 states across the nation. To be considered, prospective patients must: be over 18 years old, be a US citizen or documented permanent resident, be uninsured, and meet certain income requirements. Medicare and Medicaid patients are not eligible. Assistance with Joint Replacement Surgery.
Drug Discount Cards
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