SSM Health Good Samaritan Hospital - Mt. Vernon issued the following announcement on Sept. 19.
Maria1 was in the middle of chemotherapy treatments when she received her first bill. Upon seeing the amount she was responsible for paying after her insurance was applied, she immediately called to cancel the rest of her appointments. She simply could not cover the cost of these lifesaving treatments – until her physician's office connected her with SSM Health's Medication Copay Assistance Program. Through this program, Maria's out-of-pocket payments were reduced to a manageable amount and she was able to successfully complete treatment.
At SSM Health, we are committed to providing exceptional care, including the medications and devices patients need to get well, stay healthy and live their best lives. Through our assistance programs, patients who qualify may be eligible to receive free or low-cost medicine and/or devices when there are financial barriers to paying out-of-pocket costs.
SSM Health has developed this Medication Copay Assistance Program to help patients with copayments for higher cost brand medications. Through this program, SSM Health specialists help patients navigate through and apply for assistance programs sponsored by pharmaceutical companies.
These programs offer financial assistance for qualifying patients to help lower their out-of-pocket cost.2 Medications commonly covered under this program include specialty drugs for anemia deficiencies, oncology and rheumatology. Upon approval, patients typically pay a much lower copayment – generally $25 or less – for medications that could otherwise cost thousands of dollars.
Alternately, the SSM Health Medication and Device Assistance Program offers relief for uninsured or underinsured patients. Many patients who are self-pay or underinsured find themselves unable to cover expenses associated with expensive drugs and/or devices. If medication or devices were administered to a qualifying patient during their visit, the Medication and Device Assistance Program team will work with the drug or device manufacturer to replace the medication or device. Replacing these items allows us to remove the patient charges for that medication or device.
For example, Henry1 was prescribed weekly infusions of a costly branded medication to treat an autoimmune disease. As a self-pay patient, he was responsible for $27,518 for each infusion, which quickly added up to more than $110,000 in out-of-pocket costs. By enrolling Henry in the Medication Assistance Program, we were able to request and receive replacements directly from the drug manufacturer for the branded medication administered during his treatments. As a result, we were able to credit Henry's account for the full cost of the infusion, removing from him the financial impact of that drug.
To date these new programs have helped more than 200 patients system-wide, with the expectation of obtaining over $3 million annually in patient assistance.
"Our Mission calls us to assist patients in need, and we are doing that by helping reduce their out-of-pocket costs," said Megan Wampler, Strategic Sourcing Manager – Supply Chain, SSM Health. "Our founding sisters cared for patients regardless of their ability to pay, and these programs are a direct extension of this commitment. We are excited to now have dedicated resources system-wide to help our patients obtain more affordable medications and devices."
Other medication assistance programs across SSM Health also help patients with high out-of-pocket costs, including the SSM Health Pharmacy Concierge Service in St. Louis. This program embeds pharmacy technicians in physician offices, who work directly with insurance providers and pharmaceutical companies to obtain prescription medications (dispensed in a retail pharmacy setting) at no charge or at a reduced cost for qualifying patients.
If you need assistance paying for essential medications, or know someone who could benefit from this program, please email MedsDeviceAsst@ssmhealth.com for more information about qualifying.
1All patient names in this story have been changed to protect patient privacy.
Original source can be found here.
Alerts Sign-up