I can't afford mental health meds!

medications

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Your mental health medications are an important part of your care, but they can also be expensive. Fortunately, you may have options for getting lower cost drugs or help covering the costs. You may be able to get discounted medications by using a drug discount card, a coupon, or an assistance program. If you have health insurance, you might have coverage through your policy. Additionally, you may be eligible for free or low cost drugs through a community health clinic.

Getting discounted medications

  1. Request free samples from your doctor for a short-term solution. Doctors get samples of medications from pharmaceutical representatives so they can help match you with the best medication for your needs. At their discretion, your doctor may provide you with free samples of your medication, even if you’re already taking it. Tell your doctor that you’re having trouble paying for your meds and ask if they’ll supply you with samples.[1]
    • They may only give you enough medication to get you through a few days of treatment, but it’s possible they’ll give you a month’s worth of free samples.
  2. Ask your doctor if generic medications will work for you. Unfortunately, brand name medications can be very expensive, even if you have insurance. It’s possible that the brand you’re using has a generic version or that you can switch to a medication that is available as a generic. Talk to your doctor about switching to a generic if you’re currently using the brand name version of your medication.[2]

    • Depending on the medication you’re taking, generics are on average 80-85% cheaper than the brand name alternative.
  3. Sign up for a prescription discount card if one is available. Most prescription discount cards are free to you if you meet their eligibility requirements. Typically, they’re only available to people who are uninsured, but it’s still worth checking into your options even if you have insurance. Look for prescription discount cards through the following:[3]

    • Your medication’s manufacturer, which you can apply for through their website.
    • A county, state, or federal program.
    • FamilyWize.
    • Partnership for Prescription Assistance.
    • Together Rx Access
  4. Search for online coupons for the medication you’re taking. Coupons can also help make your medication more affordable, especially if you’re taking a brand name medication. Do an online search for coupons or check websites that help you manage your prescription costs. Print any coupons you find so you can supply them to your pharmacy.[4]

    • For example, PatientAssistance.com offers printable coupons for some medications.

    Tip: Coupons might be a great option if you don’t have insurance and your current medication isn't available as a generic. The coupon might give you a steep discount on your medication until a generic becomes available.

  5. Apply for payment assistance through a nonprofit agency. You may not have to pay for your prescription meds alone, as some nonprofit agencies provide payment assistance. Review the eligibility requirements for prescription assistance programs to see if you’re eligible. Then, apply for assistance if you find a program that is right for you.[5]

    • For instance, NeedyMeds offers assistance to people who have a low income and no insurance: https://www.needymeds.org/.
    • You might also try organizations like RxAssist and RxHope.

Using your insurance benefits

  1. Review your benefits summary to find out if you have coverage. When you sign up for your plan, the insurance company gives you a benefits summary that tells you exactly what they cover. Look at your prescription benefits to find out your copay and the percentage of the cost that they’ll cover.[6]
    • If you’re on a brand name medication, check your benefits to see if it’s specifically listed. Some plans limit how much they’ll pay for certain brand name medications.
    • Medicaid and Medicare Part D cover mental health medications. If you have prescription benefits from a Medicare Advantage Plan or something similar, check your plan benefits to see if your meds are covered.

    Did You Know? The Affordable Care Act requires insurance providers to cover mental health treatments at the same rates as other types of health care, which is called mental health parity. However, you may still have treatment limits, copays, or a high deductible.

  2. Call the insurance company if you want to talk to a representative. If you’re having trouble finding your benefits summary, call the phone number on the back of your insurance card so you can talk to a representative. Give them your ID number and group number so they can look up your benefits. Then, ask them about your mental health prescription coverage.[7]

    • Request your deductible amount for prescription medications.
    • If you know the name of your medication, ask the representative if they can tell you your exact coverage amount.
    • Additionally, ask how much the coverage differs between generic and brand name medications.
  3. Provide your insurance information to your pharmacy. Give the pharmacist or pharmacy technician your prescription benefits card when you go to turn in your prescription. They’ll contact your provider to get approval for your medication, which could take a day or 2 in some cases. Once they get approval and fill your medication, your pharmacy will contact you to tell you it’s ready.[8]

    • Your pharmacy should keep your insurance information on file for future visits.
  4. Apply for prescription assistance if you have a high deductible. Unfortunately, you might have great prescription benefits but only after you meet a very high deductible. This might leave you feeling like you don’t even have insurance. Fortunately, some assistance programs for the uninsured will help people who have high deductibles. Check the eligibility requirements or contact the programs to see if you qualify for help.[9]

    • For instance, let’s say your plan doesn’t cover anything until you reach a $5,000 deductible. It’s possible that a program that’s designed to help people who are uninsured might provide you discounts until you reach your deductible.

Visiting a community clinic

  1. Search online for a clinic in your area. Most regions have free or low-cost community clinics. Review a list of the clinics near you to find one that offers mental health services.[10]
    • If you attend a college or university, you might be able to get mental healthcare through the on-campus clinic.
    • Keep in mind that free and low cost clinics often have a high patient-load, so it can take time to get in to see a doctor.
    • If you’re in the United States, you can look up the clinics in your zip code or state using this search tool: https://www.nafcclinics.org/find-clinic.

    Variation: Ask your primary doctor or current therapist to refer you to a local free clinic.

  2. Call the clinic to find out if you meet the eligibility requirements for care. Discuss the eligibility requirements with a representative and explain your needs. Then, ask if you qualify for service and if any fees will apply for your treatment.[11]

    • You may be able to check your eligibility online through the clinic’s website. However, it always helps to talk to a representative to make sure the information that’s online is accurate.

    Tip: The clinic may ask to see your pay stubs or prior year tax returns to prove that you qualify for services through their clinic. Be sure to bring any requested materials to your appointment.

  3. Make an appointment to see a provider at the clinic. Ask the clinic representative to schedule you for a mental health care appointment at the earliest date that’s convenient for you. Find out what materials you need to bring to your appointment, such as a list of your current medications and your patient intake forms. Be sure to keep your appointment because you may be dropped as a patient if you miss it.[12]

    • Demand for free and low cost health services is very high, so the clinic may refuse to offer you more appointments if you don’t show up. Your time slot could have been given to another waiting patient.
  4. Ask your doctor about free or low cost mental health medications. Many clinics supply you with your medication, often for free. Discuss these options with your doctor to find out which medications might be available to you. Additionally, ask about the cost of your medications.[13]

    • You’ll likely need to attend regular appointments to continue receiving your medications. Schedule your appointments in advance so you don’t risk running out of your meds.

References

  1.  https://www.mhanational.org/how-can-i-get-help-paying-my-prescriptions
  2.  https://adaa.org/finding-help/treatment/low-cost-treatment
  3.  https://www.mhanational.org/how-can-i-get-help-paying-my-prescriptions
  4.  https://www.nami.org/find-support/living-with-a-mental-health-condition/getting-help-paying-for-medications
  5.  https://www.nami.org/find-support/living-with-a-mental-health-condition/getting-help-paying-for-medications
  6.  https://www.mentalhealth.gov/get-help/health-insurance
  7.  https://www.nimh.nih.gov/health/find-help/index.shtml
  8.  https://www.nami.org/find-support/living-with-a-mental-health-condition/getting-help-paying-for-medications
  9.  https://www.mentalhealth.gov/get-help/health-insurance
  10.  https://www.nafcclinics.org/find-clinic
  11.  https://www.vhcf.org/looking-for-help/medical-care/free-clinics/
  12.  https://adaa.org/finding-help/treatment/low-cost-treatment
  13.  https://www.vhcf.org/looking-for-help/medical-care/free-clinics/

Treatment & Resources