How can I get assistance with the 20% that Medicare does not cover?

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PatientAdvocateFoundation (Organization (Verified) ) - 04 / 21 / 2011

There are multiple strategies that may be employed to help with unpaid medical bills. You may want to discuss options with your treatment facilities on ways to reduce or eliminate your out of pocket expenses:

For assistance with Part A or B cost, apply for financial assistance through the billing office at your provider’s office or medical facility.

You may first need to apply and be denied for Medicaid or one its programs, such as Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiaries (SLMB) Program to qualify for financial assistance from the hospital. To apply contact your State Department of Social Services in the State where you reside.

Co-pay relief programs may be able to cover some of your pharmaceutical co-payments. Check with each program to see what is covered. You can also contact Patient Advocate Foundation’s Co-Pay Relief Program at 1-866-512-3861 to see if you qualify for assistance with your co-payments or explore websites such as www.pparx.org for a list of programs by disease.

Negotiate discounts or payment plans with the hospital or medical provider. Some providers will offer a discount for prompt payment of your balance.

Drug replacement programs may be available to assist you by providing medications to your physician’s office specifically for your use. Discuss these programs with your physician.

Contact a disease specific organization to see if there are any financial grants available to assist you. These programs vary widely and may pay for transportation or other related expenses. Patient Advocate Foundation’s National Underinsured Resource Directory can lead you to the best resources for you needs. Visit http://www.patientadvocate.org/help4u.php

For assistance with Part D cost, apply for Extra Help through www.ssa.gov that offers qualified individuals with extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug Program.

Some states offer a State Prescription Assistance Plan. Explore the site http://www.needymeds.org/state_programs.taf to learn more about the your state.

Discuss generic alternatives with your physician if brand named drugs are too costly.

We encourage the review of our publication, A New Approach: A Simple Dialogue between the Patient and Provider about the Cost of Medical Care available at http://www.patientadvocate.org/pdf/pubs/a_new_approach.pdf.
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