When Insurance Isn't Enough: Catholic Charities ‘MediAppS’ Role in Providing Access to Essential Medication

By SHEILA FILLA

Imagine going to the pharmacy to pick up a newly prescribed medication that is essential to your health and well-being. As the pharmacy technician rings up your medication, she states, “Your total is $689.” You politely ask that they run the prescription through your insurance company. The response, “We already did. The retail price for a one-month supply is $1,125. Your insurance paid $436.” You quietly state you cannot afford to pay the remaining balance and walk away.

This scenario is common for many low-income families. The medication may be a blood thinner to reduce the risk of heart attacks, an inhaler for breathing issues, or insulin for a diabetic. Many in our community have social security benefits as their only source of income. This forces them to choose between medication, food, or utilities. Others are starting a new job and waiting for their health insurance plan to become available to them.

In 2003, Catholic Charities developed a Medication Application Service (MediAppS) program to help with these types of situations. The program consists of two parts: Emergency Assistance and the Patient Assistance Program.

Emergency Assistance provides short-term help with prescriptions costs to individuals who do not have insurance or are under insured. To be eligible for Emergency Assistance, a person must have a household income of 300% or below the federal poverty level. The request for Emergency Assistance often arises during a crisis when a person is suddenly without insurance, or unable to afford the copay.

The Patient Assistance Program (PAP) is a longterm solution and involves collaborating with pharmaceutical companies who offer medications free of charge to qualifying individuals. Our MediAppS Coordinator assists clients with the application and enrollment process, and works with prescribing providers to obtain the required signatures and written prescriptions. Our Coordinator also manages refill requests for each client.

Many of the medications MediAppS assists with treat chronic diseases such as asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, high blood pressure, high cholesterol, depression, chronic pain, and more. We also assist with prescribed over-the-counter medications, supplies, and/or medical devices that are not covered by insurance. Examples include diabetic supplies, eyeglasses, hearing aids, incontinent products, nebulizers, nutritional/protein drinks, orthopedic shoes, and wheelchair batteries.

MediAppS is a cost-free and unique service that is unduplicated in southeastern Minnesota. Referrals come from medical providers, pharmacies, county social service departments, insurance companies, and other agencies.

If you feel you could benefit from the MediAppS Program, please contact Sheila Filla at 507.494.8288 or email sfilla@ccsomn.org. As the need is always greater than the resources, we are actively taking donations at our website www.ccsomn.org, to ensure we can help as many people as possible.

Sheila Filla is the MediAppS Coordinator for Catholic Charities of Southern Minnesota.