June 2, 2023

How to Apply For Enbrel Assistance Programs


Kirby Horton

Medicare Part D has been a God-send for many senior citizens who may be on a tight income and have a limited budget to spend on prescription medicine. However, for those senior citizens who have a lasting illness, the Medicare Part D coverage gap can be a tough realization. The coverage gap or donut hole is often talked about by the second quarter of the year. How does it work, what is it, and why is it there?


To reduce the cost of Medicares Part D coverage, the coverage gap was created. Each year, a limit for Part D is determined. In 2007, the yearly amount was $2400. The yearly amount was increased in 2008 to $2510. In 2009 the limit is $2,700. The limit is calculated on the total costs of the prescription medications that you receive. This includes your co-pays and what the insurance company pays. For example, if a drug is $550 and the recipient pays $50 and the insurance company pays $500, the amount that is applied to the annual amount is the full $550 the annual amount is the full $550. You are responsible for all of your prescription drugs 100% during the time you are in the donute hole or coverage gap. While in the donut hole or coverage gap, many Medicare Part D plans will provide some type of coverage for generic drugs. The cost of most generics is so small that the benefit of having them covered by a Medicare Part D plan isnt that great of a benefit. Everyones situation is different so for some patients it might be worth it to have prescription coverage for their generics. Chronic health problems which often require expensive prescription medicine for treatment result in Medicare Part D people getting to the donut hole or coverage gap in a matter of months. We have seen people get to the donut hole or coverage gap as early as February. The whole point for the donut hole was to steer patients to purchase less costly pharmaceutical products when possible. That is okay for those people who have that option but it punishes those who must take costly prescription medications because nothing else works. Patients with rheumatoid arthritis can fall into the coverage gap within 2 or 3 months due to the high price of Enbrel. Halting their medicine which has potentially disabling consequences or paying for their medicine at full price is frequently the only option available for these people. About $1,500 per month is the cost of Enbrel. There are many seniors who are not able to pay that. Some people will be able to take advantage of patient assistance programs due to their lower income. The best way to get low cost or free medicine is to talk to the manufacturer. Call the company and ask about their Prescription Assistance Program. Most all pharmaceutical companies offer these programs, which enable people to receive prescription medicine they need at a price they can afford. A lengthy application co-signed by your healthcare provider is typically necessary for entry into the program. Patient Assistance Programs run by drug companies have been in existence for over 23 years. These programs are designed to assist eligible patients who cannot afford their drugs due to low income or other financial problems. Drug companies did not want their low income patients to be forced to make a choice between paying for life saving prescriptions or for paying for rent or groceries. As a result, patient assistance programs came into being as part of the company’s philanthropic efforts. Until relatively recently, very few people knew about these programs or could follow the complicated application process that was required for participation. In many cases multiple applications had to be filed with several different drug manufacturers in order to gain access to prescription assistance programs. The drug companies think that offering information on their websites and toll-free numbers is all that people need to access PAPs. They dont grasp the inability of many patients, particularly those on several prescription medicine from 2 or more doctors to follow through with the fragmented application process. It also places an unfair burden on the physicians that are already swamped with paperwork. Fortunately there are companies that will perform the task for people for a fee. These prescription assistance companies will generally coordinate the process from beginning to end. Of course the prescriptions are free and if patients are capable of doing it themselves they should, but for those patients that just do not have the patience to do it themselves, the hiring of a firm to do the job is a better option than not taking the prescriptions they need.

Do you need

prescription drug help

? Kirby Horton has been helping Americans with their healthcare needs for close to 30 years. He is the Founder of

Rx Help

, a Prescription Assistance Company. He can be reached at 866-960-9497 and you can follow his blog at

Rx HELP Blog


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