Pharmacy Assistance Programs

Prescription Assistance Programs

 

Helping patients obtain their medications regularly helps improve medication adherence, chronic disease management, and patient qualify of life. Applying for prescription assistance programs can be complicated and time consuming for patients due to varying qualifications, criteria, and processes with each pharmaceutical company.

CHI Health Partners chapters in Kearney, Omaha, and Grand Island offer a prescription assistance program to help providers and their patients navigate the pharmaceutical company application process for many brand-name medications. These programs are called Medication Access Program (MAP) in Kearney and Prescription Assistance Program (RxAP) in Omaha. 

Assistance Services can include:

  • Determining which pharmaceutical assistance programs a patient may qualify for, based on medication, income, and insurance status. Programs work with most pharmaceutical company prescription assistance programs.
  • Helping patients through the initial application, re-enrollment, and refill processes.
  • Filing appeals and researching other sources of prescription support for those individuals with extensive medication needs who are not eligible for the traditional assistance programs. 

The programs help fill over 6,000 prescriptions for more than 2,000 patients in a typical year. The annual savings for patients resulting from these applications is approximately $13 million.

CHI Health Partners providers, population health coaches, and clinic/hospital staff can refer patients to these programs.

RxAP will refer to the CHI Health Partners Medication Therapy Management program to review patients’ medications and determine optimal therapeutic outcomes or provide options that may be more affordable long term.

 

  

Medication Therapy Management

 

CHI Health Partners Medication Therapy Management (MTM) program helps patients get the best benefits from their medications by actively managing medication therapy and by identifying, preventing, and resolving medication-related problems. The program helps patients understand their medications, and optimize patient adherence to their prescription regimen to help achieve better outcomes. 

Patients referred to the MTM program through a UniNet provider, population health coach, clinic/hospital staff can be counseled on:

  • Medication affordability: If cost is prohibiting a patient from taking their prescription, the MTM staff will analyze the medication to ensure it’s the best option, determine the patient’s insurance coverage, identify if they may qualify for other coverage options (ex. Medicare Extra Help, Medicaid), and research generic options or a more affordable pharmacy. The MTM staff follows evidence-based guidelines when recommending alternative medication options to the patient’s provider. 
  • Medication instruction: Patients can receive tips on ways to keep their medications straight, and how to take them properly. If a patient is not taking their prescription, MTM staff will work with the patient to help determine the cause for non-adherence and offer solutions.
  • Potential drug interactions and medication-related side effects: For a patient with multiple prescriptions, MTM staff will review the list of medications, determine if they are up to date, look for potential interactions and problems, and find out if the patient is experiencing any side effects.
  • Medication reconciliation: For patients on several medications and/or seeing several different providers and specialists, MTM staff will update the patient’s record with current medications.

Insurance research regarding medications is part of the MTM program. MTM staff does not do routine prior authorization verification, but will investigate why a patient needs a prior authorization for a medication or provide other potential medication options.