Frequently Asked Questions and Answers
Q: What exactly is a patient assistance program and how does it work?
A: Patient assistance programs are exactly as it reads, which are programs implemented by pharmaceutical companies to help patients financially with the affordability of their prescription medication. Pharmaceutical companies have created these programs by limiting their selection of medication that they manufacture, which either tends to be costly and/or life dependant, to allow patients who normally couldn’t afford their prescriptions, have access to them even though they may have limited insurance coverage, no insurance at all, or are in a financial bind.These companies are able to create these programs because of tax incentives given to them by the federal government, which in return allows the Pharmaceutical companies to offer their medication at a discounted price or even free as long as you meet their guidelines.
Q: Is the initial phone consultation free?
A: Yes, any discussion over the telephone whether it be advising or initial consultation is absolutely free (unless you elect to use our one time consultation service fee which only occurs after a you’ve spoken to a representative and it is determined that this is your best available solution). The only time you are charged is when you give TPHI consent to start an application process for any program, and you send us back directed portions of initial paperwork we sent to you the patient.
Q: What is the total cost of the program for the year and how am I charged for TPHI’s services?
A: The total cost for TPHI’s services is depends on approval or denial into anyone of the programs we offer assistance with, or if you elect to use our services for a one time consultation for a program we don’t offer assistance with. The initial filing and processing of your application carries a $25 processing fee. Then if you are approved for any program, you will be charged $45 for each month supply of your medication. This charge does not change whether you are applying for one or multiple medications; it is one flat rate of $45 a month. When you calculate the total cost for TPHI Account Management (TAM) services for the first enrollment year, it equals $565 no matter how many medications you are approved for. If you are denied for all the programs you are applying for, other than the initial $25 processing fee you will not be charged for anything else. If you are utilizing our one time consultation fee service, the total charge for this service is $65. This is a combination of the initial $25 processing fee and $40 consultation fee, which is only charged after you been approved for assistance for a program, so you know how to personally manage your account (PAM personal account management), which TPHI does not manage.
Q: Do I need to be prescribed the medication before I apply for it?
A: Yes, the program applications that are completed act as a prescription itself. A license health care provider must complete the medication information section on your application form as if it were a regular prescription that you would normally take to the pharmacy. If you have not been prescribed a medication on our list and would like to, we strongly suggest that you consult with your physician to see if it’s possible to switch your current medication or gain a new prescription for that particular medication. Once you’ve been prescribed than we can proceed with our services.
Q: What exactly am I paying for?
A: The minimization of human error is the first thing you don’t have to worry about when enrolled into our program. Everyday consumers/patients who are looking for financial relief from their prescribed medication seek any available resource to help ease the financial burden of their prescription cost. We assists in getting, what may be for you expensive monthly prescription cost to one flat low monthly fix rate no matter how many medications you are applying for and no matter how many programs you are enrolled in. Often when patients call the pharmaceutical companies or fill out their application they are denied because of given answers because of miscommunication. We make the application process easy for you because of the knowledge we’ve obtain from our experience in the industry. With all the federal laws and financial guidelines, we strategically figure out what is the best solution for enrollment to make sure you are approved for any program. Our experience has also taught us that these programs are a bit of a burden on health care providers because it is added work to their already busy schedule. We’ve seen patients miss refills because of health care providers being unaware of the time and dates when refills can be placed. We’ve also seen health care providers accidentally give patients medication away because they were mistaken for samples. We eliminate this as much as possible by removing the burden of account management off their hands. We know the ins and outs of patient assistance account management, and make sure you utilize the pharmaceutical programs in its entirety. We are your personal representative when dealing directly with pharmaceutical company (s) and do everything from communicating acceptance/denial into a program, to alerting you and your health care provider as to the expected delivery date of your medication, to placing refill and replacement orders if your medication is lost or given to other patients as samples, to even starting a new enrollment year when your cycle is complete (No added cost for re-enrollment).
Q: Does the medication have to be delivered to my doctor’s office; is there any way it can be sent to my house instead?
A: There are only a few medications that are directly delivered to the patient’s home address, and for the most part the medication is sent to your health care providers. With our knowledge we are aware of exceptions and can communicate these exceptions with you during our consultation. But we must forewarn you, that this request is not often granted because of certain legal ramifications on certain medications. Some medications carry liability issues because of their delivery methods, which involves temperature control or regulation of distribution in accordance with federal compliance.
Q: If I’m already approved for a medication and I’m newly prescribed a medication on the same or different program, are there any additional cost, and how would this procedure take place?
A: We submit on your behalf a brand new application as if it were a new application if it’s a different program. If the medication is on the same program that you have already been approved for, then this requires us to coordinate your refill and new submission so that it aligns with your enrollment cycle. It is our pleasure to further assist you with easing the financial burden of your prescription medication, and there is no additional cost if you are adding a medication that is on our list.