Do you lack health insurance but make too much money to qualify for government assistance? Are your prescription co-payments so high that you can’t afford other basic necessities? Help may be available from pharmaceutical companies in the form of patient assistance programs (PAPs) and co-pay programs, not only for HIV medications, but also for hepatitis B and hepatitis C treatments.

PROGRAMS FOR HIV

Co-Pay Programs

These programs offer assistance to people with private health insurance for the co-payments required to obtain HIV drugs at the pharmacy. Some companies offer co-pay assistance for all of their drugs, including non-HIV drugs.

Patient Assistance Programs and Welvista Programs for HIV

Patient Assistance Programs (PAPs) offer free HIV drugs to people with low-incomes who do not qualify for any other insurance or assistance programs, such as Medicaid or AIDS Drug Assistance Programs (ADAPs). Different company programs have different eligibility criteria, notably incomes that do not exceed a certain percentage above the Federal Poverty Level (FPL). The 2012 FPL income for one individual is $11,170. It is adjusted based on family or household size. A complete table is at http://aspe.hhs.gov/poverty/12poverty.shtml.

Unless otherwise stated, companies ask for verification of income, usually in the form of a federal income tax return. Companies also generally consider household income, meaning that a married couple that files joint taxes would be judged on their combined income. People who file individual income tax returns would only have their individual income considered. Always apply for an exception if told you are not eligible.

A special program which is overseen by the Heinz Family Philanthropies, and managed by Welvista, a non-profit mail-order pharmacy based in South Carolina, has been initiated to make it easier for people on ADAP waiting lists to access their HIV medications from one location rather than having to access multiple industry PAPs to obtain their medications for different manufacturers. Thus far, Welvista is working with six HIV drug companies to provide HIV drugs for free to individuals on ADAP waiting lists.

Please note:

	Some companies are using Welvista for ADAP waiting list patients.
	Some companies are covering waiting list patients through their own PAPs.
	Some companies are also covering ADAP disenrolled clients through their own PAP programs and some are not.
	If an ADAP patient has been disenrolled because the state has lowered FPL eligibility, the drug company or Welvista FPL may also be too low to cover them. Check the individual company PAP criteria; and always apply for an exception if you are told you are not eligible.

It is also important to note that, as of September 12, 2012, people living with HIV and their health care providers can use a single application form to apply for patient assistance programs maintained by different pharmaceutical companies. Prior to the development of the common form, patients and their providers had to fill out different sets of paperwork to apply for assistance from each company–common for complicated, multi-drug regimens. This was a time-consuming and burdensome process. and the new streamlined application has the potential to provide faster, easier access to live-saving medications. To access the Common Patient Assistance Program Application (CPAPA), click here.

PROGRAMS FOR VIRAL HEPATITIS

Co-Pay Programs

These programs offer assistance to people with private insurance for the co-payments required to obtain HBV  and/or HCV drugs at the pharmacy.

Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)

These programs offer free HBV and HCV drugs to people with low-incomes who do not qualify for any other insurance or assistance programs, such as Medicaid or Medicare. Different company programs have different eligibility criteria based on the Federal Poverty Level (FPL). The 2010 FPL income for an individual is $10,830 annual income. It is adjusted based on family or household size. 200% FPL is $21,660 annual income for an individual and 300% is $32,490 annual income. A complete table is available at http://aspe.hhs.gov/poverty/10poverty.shtml. Unless otherwise stated, companies ask for verification of income, usually in the form of a federal income tax return. Companies also generally consider household income, meaning that a married couple that files joint taxes would be judged on their combined income. People who file individual income tax returns would only have their individual income considered. Always apply for an exception if told you are not eligible.

Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)