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What Do I Do When I Can’t Pay for My Migraine Medication?

Migraine-Medication

It’s no secret; migraine treatment can be expensive! Without help from insurance, costs can quickly build to an unmanageable amount, which leaves many to ask – what should I do when I can’t afford the help I need? One thing is for certain; you cannot live a quality life without help if you suffer from chronic migraine syndrome. Here are some options for the uninsured:

State Assistance

Also known as Medicaid, this financial support is state and federally funded. Individuals apply within their state to qualify for assistance with medical care and prescription medication coverage. Medicaid is geared toward assisting low-income families, pregnant women, the elderly and people with certain disabilities or conditions who cannot afford the care and treatment they need. Funding is granted directly from the state agency or through a managed health care plan (Medicaid managed care) and coverage is based on income. Check to see if your state is expanding Medicaid and determine what that means for your care. You can also reference this chart to find out the amount for which you might qualify. 

Medicare

Medicare is a federally funded health insurance program that supports any U.S. citizen who is:

  • Over the age of 65.
  • Has worked long enough to be entitled to social security or railroad retirement benefits.
  • Is a government employee or retiree who has paid Medicare payroll taxes while employed.
  • Is under the age of 65 and has been granted social security disability benefits.
  • Has been diagnosed with Lou Gehrig’s disease or has permanent kidney failure requiring regular dialysis or a transplant.

Medicare also offers support to people with certain other conditions. There are four program types:

  1. Medicare Part A: Inpatient hospital and limited nursing home coverage.
  2. Medicare Part B: Covers certain outpatient physician and nursing services, vaccines, diagnostic testing, certain medical treatments and medications administered during clinical visits.
  3. Medicare Part C (Medicare Advantage): Enables individuals to choose a private insurance provider for their Medicare coverage. With Medicare Advantage, enrollees are privy to part A, part B and additional medical benefits.
  4. Medicare Part D: Prescription drug insurance. Anyone who qualifies for part A or part B will also qualify for part D. Part D coverage is provided by a private insurance company (like part C). Enrollees share the cost of prescription medication with the government. Once an enrollee reaches a certain out of pocket amount, the government intervenes and pays the high cost.

To find out if you are eligible for Medicare assistance and what your premium might be, use this tool.

Patient Assistance Program (PAP)

Almost every pharmaceutical company in existence offers a patient assistance program. If you meet financial requirements, your doctor can fill out the necessary forms to qualify you for free medications. Typically, these companies are generous and deliver a 90-day supply, which can be renewed by resubmitting the forms. To qualify, most PAPs require:

  • That you be a U.S. Citizen.
  • No pre-existing prescription drug insurance coverage for the medications you require.
  • That you meet the financial requirements for assistance. Refer to the Federal Poverty Level Calculator to find out if your income level qualifies you. 

Children’s Health Insurance Program (CHIP)

CHIP is a federal and state funded program put into place to cover child health care costs for families that did not qualify for Medicaid but are still considered low income. In some states, CHIP is integrated into Medicaid while in others, it exists as a separate program. To qualify, children must be U.S. citizens and 18 years of age or younger. 

Veterans Administration (VA)/Department of Defense (DoD)/TRICARE

If you, a family member or your spouse has ever served within a military branch, you may be eligible for government-assisted care through a few different agencies. The Department of Defense covers all active and retired service members (and their families) from all branches of the military. The Department of Veteran Affairs covers veterans and their eligible family members. TRICARE is the Department of Defense’s managed care program for active duty military, their families, retirees and their families. Each program has a different set of benefits and requirements for eligibility. Visit their websites to learn more.

Social Service Agencies

Find out if there are local social service agencies that will help pay for doctor appointments and medications or that can at least point you in the right direction for help.

Free Clinics

Check to see if there is a free clinic in your area. They might assist low-income individuals with care and may be able to provide patients with certain medications.

Emergency Care

It’s important for migraine sufferers to know that in the event of an emergency, hospitals are required by law to provide treatment regardless of your inability to pay. You will be billed for service once treatment is administered, but most hospitals will work with you to procure payment without damage to your credit score. 

Find Areas Where You Can Save

You may feel like there are no corners left to cut and that might be true but try once more to re-evaluate your spending habits to identify areas where you could pinch a few extra pennies. Do you drink soda? Cut it out of your grocery list and stick to water instead. Do you eat out more than you should? Plan a better shopping list and save money by opting to eat in. Start clipping coupons and participate in grocery incentive programs. Consider cutting your cable or downgrading your cell phone plan. Instead of buying books or movies, get a library card and rent. It may not seem like a lot, but you’ll be amazed at how quickly the little expenses add up!

You may also be interested in: Tips for beating the financial burden of migraines

Most importantly, don’t lose hope. The medical and insurance world can be a bewildering and complex place to traverse but there are several resources available to help you figure out a game plan for treatment and medication.

You don’t have to suffer alone.

Start with the above list of resources and consider every possible option for financial assistance. Do some research on local aid resources like free clinics or social service agencies. You can also visit the National Institute of Neurological Disorders for a list of additional patient assistance resources. Lastly, reach out to your migraine community for support. Chances are, you aren’t the only one struggling to afford care and you might gain insight through the plights of others.

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