By Nora Hansen, CPhT
Patient Billing Representative and Certified Oncology Pharmacy Technician, Illinois Cancer Specialists
This is the second in a series of three Expert Tips articles from Nora Hansen. If you missed her first on how to craft an effective appeal, you can find it here.
Are your Medicare patients struggling with copays?
A cancer diagnosis can be devastating physically, mentally, and financially. Our job as billing representatives, financial counselors, navigators, or advocates is to worry about the financial impact, so the patient doesn’t have to.
With the cost of many oral oncology treatments in the thousands of dollars, it’s critical to assess a patient’s financial status as soon as possible. Patients are more adherent to their treatment if they aren’t worried about the expense.
One of the services I recommend patients to is Low Income Subsidy.
Low Income Subsidy (LIS), sometimes called Extra Help, is a Social Security program set up to assist with prescription drug costs such as Premiums, Deductibles, and Copays.
To qualify, patients must be enrolled in Medicare and meet certain income criteria.
Signing up is quick and easy:
- Online at: gov/benefits/Medicare/prescriptionhelp.html
- Call: 800-772-1213 (TTY 800-325-0778)
- Or in person at the patient’s local Social Security Office
Enrollment in this program is a real game-changer for patients, putting the $170/ month Medicare premium plus the cost of the Part D plan back into the patient’s pocket. LIS also signs the patient up for a Part D plan if they are not already enrolled, with no penalty. Depending upon the patient’s income level, it offers low cost or no cost premiums, deductibles, and out of pocket maximums.
LIS offers peace of mind to patients, knowing that they won’t be excluded from life-saving medication due to inability to pay.
I recommend that patients sign up as soon as possible as it can take up to three months to be approved for the program.
Which other resources have you used for patients that are struggling with the cost of medications? Email them to partners@policyreporter.com so we can share with the community.
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