Prescription Advantage

Massachusetts' Prescription Drug Program for Seniors and People with Disabilities

Prescription Advantage is administered by the Commonwealth of Massachusetts

Executive Office of Elder Affairs

<<Click HERE to Link to PrescriptionAdvantageMA.org for Additional Info>>

https://www.prescriptionadvantagema.org/

• There are no fees to join Prescription Advantage if your income is below 300% of the Federal Poverty Guidelines (FPG). You must still pay any of your Medicare Part D premiums and co-payments not covered by Prescription Advantage.
• Members with incomes between 300% and 500% of the FPG must pay a $200 annual enrollment fee to join Prescription Advantage.
• People on Medicare who have incomes above 500% of the FPG are not eligible for Prescription Advantage.

For a complete rate schedule, call Prescription Advantage at 1-800-AGE-INFO (1-800-243-4636), or TTY: 1-877-610-0241, or see <<Click HERE for Prescription Advantage Rate Schedule Guide (April 2024)>>

<<Click HERE for Prescription Advantage Authorized Representative Form>>
 

Send or fax the completed application and copies of your required

documentation to:

Prescription Advantage

P.O. Box 15153

Worcester, MA 01615-0153

Fax: 508-793-1133

<<Click HERE to Apply online>>

<<Click HERE for Prescription Advantage Online Application Instructions>>

<<Click HERE to Print Application>>

<<Click HERE for Prescription Advantage Application Instructions>>

Novo Nordisk Patient Assistance Program Provides Medications to Qualifying Applicants at No Charge | Ozempic

>>Click HERE to link to Needy Meds for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version of Ozempic Co-Pay Assistance Application>>

ELIGIBILITY REQUIREMENTS:

You may qualify if your household income is at or below 400% Federal Poverty Level.

(single/54,384) (married/73,248)

Johnson & Johnson Patient Assistance Foundation - Xarelto, Imbruvica,

>>Click HERE to link to Johnson & Johnson Patient Assistance Foundation for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

Review this guide to learn more about Janssen’s patient assistance offering, including details on eligibility, eligible Janssen medications, and a step-by-step guide to help you navigate the process.

>>Click HERE to Link to Janssen Eligibility Requirements>>

>>Click HERE to Link to Janssen for Medicare Clients>>

To qualify for the program, 4% of your gross annual household income must be spent on out-of-pocket prescription expenses for you and/or other members of your household.

PRALUENT Patient Assistance Program (PAP) Enrollment Form

 >>Click HERE for LARGER image or Printable Version>>

Novartis Patient Assistance program for Cosentyx

>>Click HERE to link to Consentyx Patient Assistance Programs for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

MULTAQ Savings Card Program | Manufacturer SANOFI

>>Click HERE to link to Multaq.com for Additional Info>>

With the MULTAQ Savings Card you may be eligible to pay as low as $0 co-pay on each of your next 13 MULTAQ fills with no income restrictions. Maximum benefits apply. See terms and conditions here.*

 

 

Merck Patient Assistance Program for Januvia, Janumet, Janumet xr

>>Click HERE to link to Merk Patient Assistance Programs for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

Pfizer Patient Assistance Program Celebrex, Lyrica, Nitrostat, Premarin

>>Click HERE to link to Pfizer Rx Pathways for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

 

Allergan Patient Assistance Program - ALPHAGAN® P, COMBIGAN®, ESTRACE®, LUMIGAN® 0.01%, NAMENDA®, RESTASIS®, VRAYLAR

>>Click HERE to link to Allergan Patient Assistance Programs for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

For Medicare recipients, we will review your qualifying financial need based on a combination of your insurance coverage, household income, and out-of-pocket medical expenses during the application process. To help you understand the income guidelines that we use to evaluate qualifying financial need, we’ve provided the table below:

Household size Annual income

1 $77,280 or less

2 $104,520 or less

3 $131,760 or less

4 $159,000 or less

Bristol-Myers Squibb Patient Assistance Foundation - Eliquis, Nulojix, Orencia

>>Click HERE to link to Bristol-Myers Squibb for Additional Info>>

>>Click HERE for LARGER IMAGE or Printable Version>>

For Patients Applying to the Bristol Myers Squibb Patient Assistance Foundation (BMSPAF)

Whether you are applying to BMSPAF for the first time or requesting continued assistance, your application may be processed more quickly if you include proof of your household income from a Federal Tax Return or other income documentation including:

1099 forms

Social security statements

Pension statements

Two consecutive pay stubs

Note to Medicare Patients:

In addition to your application, you will need to submit documentation showing you have spent 3% of your annual household income on out-of-pocket prescription expenses for you and/or other members of your household for the year in which you are seeking assistance. Your pharmacy can provide this report.

For example – if your annual household income is $10,000, you would need to spend at least $300 on prescription expenses for you and/or other members of your household. Prescription expenses include your out-of-pocket expenses for any prescriptions filled beginning January 1st of the year you are seeking assistance.

This 3% out-of-pocket prescription expense is in addition to our other eligibility criteria, including financial eligibility. We may not be able to process your application until we receive documentation of these out-of-pocket prescription expenses.

Kind regards,

BMSPAF

PAN Foundation - 60 Disease-Specific Assistance Programs to Help Patients Pay for Out-of-Pocket Costs

>>Click HERE to link to PAN Foundation for additional info>> 

Patient Advocate Foundation - Co-Pay Relief

>>Click HERE to link to copays.org & learn more>>

NeedyMeds Drug Discount Card

>>Click HERE to link to NeedyMeds.org & Learn More>>

>>Click HERE for Printable Version>> 

$4.00 Medications

Wal-Mart, Target, Hannafords and Walgreen's all have a variety of generic medications offered for $4.00 each a month ! Also, for those with computers, you can go to www.needymeds.org to get free or no cost medications.