Frequently Asked Questions
What is Special Patients In Need?
was originally formed by a nurse in 1999 to help people who cannot afford to
pay for their medications. She named the company Special Patients In Need
(S.P.I.N.) S.P.I.N. Works with United Way, Division of Family and Children
Services (DFCS), doctors, hospitals, pharmaceutical companies, and several
other agencies across the county to help people who cannot afford to pay for
their medications. Before she formed the company she was working as a
nurse for a doctor in Moultrie, Georgia. She had many responsibilities
while working as a nurse including qualifying their patients through
pharmaceutical companies' Patient Assistance Programs. After several
years of this she decided to go out on her own to form a company to help
patients receive their medications when they were financially unable to pay for
them. She sold the company to a corporation in Atlanta Georgia many years
ago. Before she sold the company she made certain that this corporation
had nurses and other medical professionals who knew the ins-and-outs of
qualifying patients through the Patient Assistance Programs. She also
made certain that they also knew how to qualify patients who were enrolled in
Medicare “D” prescription coverage. Now there are thousands of nurses and
other medical professionals all across the country working for Special Patients
What are patient assistance programs?
Assistance Program (PAPs) is a program that the pharmaceutical companies offer
to help you with your medication if you cannot afford to pay for it.
These patient assistance programs are programs set up by drug companies that
offer free or low cost drugs to individuals who are unable to pay for their
medication. These programs may also be called indigent drug programs,
charitable drug programs, or medication assistance programs. Most of the
best known and most prescribed drugs can be found in these programs. All
of the major drug companies have patient assistance programs, although every
company has different eligibility and application requirements.
Pharmaceutical companies offer these programs voluntarily; the government does
not require them to provide free medicine Age is not a factor in order to
What are the eligibility requirements for patient assistance programs?
people are already benefiting from patient assistant programs - and there are
millions more who could be helped.
varies program by program. Generally, individuals must have incomes under
200% of the Federal Poverty Level, cannot have prescription coverage from any
public or private source, and must be a U.S. resident or citizen. Some
pharmaceutical companies require that the patient have no health insurance and
not be enrolled in the federal government’s Medicare “D” prescription drug
(2012 FPL Guidelines)
for most patient assistance programs, your total household income must be less
than 200% of the Federal Poverty Level. Some programs are 300% or lower.
of Persons in Family or Household
Contiguous States and D.C.
each additional person, add
assistance programs require that you do not currently subscribe to private or
public sources of prescription coverage or that your prescription coverage has
reached its annual limit.
You must be
a United States resident or citizen to be eligible for any of these programs.
pharmaceutical company will have their own eligibility requirements. Income and
lack of prescription drug coverage is normally the most important criteria for
determining whether someone can enroll. The patient also must not qualify for
any third party coverage, such as a state or federal program that would cover
the cost of their medicine including Medicare “D” regardless if the patient is
in their donut-hole or not.
income criteria vary with family incomes ranging from below the poverty level
to up to $ 60,000. These are for medications that are used to treat things such
as Multiple Sclerosis, Aids, Cancer, or other rare disorders. Medications for
these specific illnesses are extremely expensive and are therefore subject to
different guidelines by the companies that manufacture them.
factors such as number of people in the household and total medical cost may
also be considered.
What questions will applicants be prompted to answer?
be prepared to provide the following questions regarding yourself and your
State of residence and ZIP code
or not you are a US citizen
gross annual household income of each person living in the household
of people living in household
name of prescription medicines that you are currently taking or have been
prescribed along with each medicines milligrams and how often per day you
take each medicine
allergies that you may have to medicines
of health insurance and/or prescription coverage (if applicable) including
whether or not you are enrolled in Medicare “D” prescription coverage
responses to these questions are completely confidential.
What other documents are needed in addition to the above
It may be
required that your physician provide additional information besides what was
requested of us. In most cases, your physician will be required to
provide a prescription for the specific medication, doctor’s information, along
with their signature.
Can I apply if I am enrolled in Medicare “D” prescription
assistance programs disqualify all those eligible for the full low income
subsidy through Medicare Part D. If you do not qualify for the full low income
subsidy, you should attach documentation to your application from Social
Security Administration stating that you are ineligible. This information
varies greatly between different companies and is subject to change without
notice. It is not uncommon for exceptions to be made for those facing financial
Can my application be rejected by the pharmaceutical companies
that manufacture my medications?
not every application to a patient assistance program will be accepted. As
these services are provided for free by the pharmaceutical companies, it is at
their discretion who they reject and for what reason. It is unlikely that you
will be disqualified for anything other than failing to meet all eligibility
requirements. It is possible to have the rejection overturned by
submitting your application for appeal.
Is every medication available free?
No. Normally only brand name products have programs. This is because they
are more expensive and have no generic available on the market. Once they go
off patent and the patient can now buy it for a fraction of the brand name
cost, the company that manufactures the brand name has no reason to make it
available for free. Once the medication goes off patent and out of the
programs, they normally are sold for as low as four dollars for a month’s
supply through many pharmacies such as Wal-Mart pharmacy, Walgreens, CVS, etc.
Where do the medications come from?
medications are supplied and sent to your doctor (in some cases they are
delivered directly to the patient) directly from the drug manufacturer and are
normally filled for a 90 day supply.
What do I have to do to apply for a patient assistance program?
of the pharmacy companies have applications that must be completed and signed
by both the patient and the doctor. All you have to do is contact
our office, that’s all. We do the rest. When you contact us, we can
determine if you qualify over the phone in just minutes. We will ask you
if you have any prescription drug coverage and if you are enrolled in Medicare
“D” prescription drug program, veteran's status, eligibility for public
insurance programs and income and asset information. We will also ask
• Proof of
income, such as federal income tax statements or pay
• Medicaid or
insurance denial letters
• A prescription from
• Patient consent
forms that is included with the application.
applications will request information about your physician.
may require the signature of the physician, the patient, or both.
physician's office will include either specific prescription information or an
actual prescription to be sent along with the application to our office. We
will either mail or fax the application to the pharmaceutical company in
accordance with their specific instructions.
How long does it take for my medicine to arrive?
companies are committed to getting free or nearly free prescription medicines
to eligible patients as quickly as possible, each participating patient assistance
program has its own timeline.
It can take
anywhere from four to six weeks for medication to arrive after approval for
participation in the program once our fee has been paid. In most cases,
the pharmaceutical companies will deliver the patient’s medications directly to
the patient’s doctor once the applications have been processed. In very few
circumstances the pharmaceutical companies will deliver the patient’s
medications directly to the patient.
I have health insurance, but no prescription insurance; am I
eligible for patient assistance programs?
cases, the answer is yes.
I have coverage for prescriptions with my health insurance but I
have reached my coverage limit. Am I eligible for patient assistance
if you have reached your coverage limit you no longer have prescription
coverage, but we suggest attaching a letter with your application that
indicates this. If you have a letter from your insurer stating that you
have used up your benefits, send that along as well.
Can Medicare and Medicaid beneficiaries qualify?
assistance program has its own eligibility criteria. Many programs provide
prescription assistance for Medicare beneficiaries who do not have full prescription
drug benefits. People who are enrolled in other public and privately sponsored
programs that include prescription drug coverage may not be eligible for
assistance; however, there are some instances in which Medicaid beneficiaries
may be eligible for certain patient assistance programs.
Can I join a patient assistance program and also have a Medicare
approved drug discount card?
may be some patient assistance programs for which you may be eligible.
Why am I eligible for patient assistance programs for some
medicines, but not others?
eligibility criteria for patient assistance programs vary from program to
program and may even vary by medicines within a program, depending upon several
factors related to your income, prescription medicines, resident state, age,
and current prescription drug coverage.
How is the medication sent to the patient?
the pharmaceutical company, and the type of medication, it will either be sent
to the physician's office, or directly to the patient's house. Some may send a
voucher that is taken to your local pharmacy and redeemed. We advise you of the
specific information on how your medication(s) is dispensed.
If applying for
more than one medication, the patient should be aware that they would arrive at
different times, since it is manufactured and sponsored by different companies.
Normally a three-month supply is sent each time.
How long can the patient get their medications through these
companies are helping patients by allowing for refills. Some have limits of
only a three- month supply, while others allow the patient to apply
indefinitely. Some have applications that are only renewed once a year, while
others require a new one every three months. Refills are not sent
automatically. For the most part, pharmaceutical companies send the
patient their medications in three months increments.
What does Special Patients In Need charge for their services?
above, the medications come free from the pharmaceutical companies. We
charge a very nominal fee so the patient can receive their medications.
Usually, the patient will receive a year’s supply of each of their
medications. You are paying us to complete all the applications that
the pharmaceutical companies require so you can receive your medications.
We also ensure that you are current on your medications. The patient can pay
for their medications using their PayPal account or they can pay for their
medications using their Credit Card or their Debit Card.
Can you give me information about specific
Patients In Need was
created to make it easier for low-income uninsured patients to get free or
nearly free prescription medicines through existing patient assistance
programs, while providing the highest level of service. The best way to find
out about a specific drug is to consult your doctor or pharmacist.