Getting Help with Prescriptions

Average SSD Payment

The average SSD payment in 2008 was $1,063 a month. Once you have received disability payments for two years, you automatically qualify for Medicare coverage.

Ohio, Michigan, Minnesota, Wisconsin, Indiana, Nebraska, Illinois, Missouri, the District of Columbia and Alabama face the 10 worst Social Security Disability Insurance (SSDI) hearing-level processing backlogs.

Hearings are held when an SSDI decision is appealed, many people have already waited 12 or more months following their application, denial and, for many, reconsideration. By the time they reach the hearing, it's not unusual for applicants to have waited two to four years for an SSDI decision.

The 10 states with the lowest wait times are Delaware, Maine, Texas, Louisiana, West Virginia, Utah, Massachusetts, Oklahoma, Connecticut and Hawaii.

The SSA reports the national average processing time for a hearing decision is now 442 days, down from 514 days in September 2008. The total hearings backlog has decreased by more than 71,000 cases since December 2008.

Last year, more than 2.8 million people filed SSDI applications, and the SSA projects 3.3 million will file disability claims in 2010. The SSA recently reported that the level of initial claims pending now exceeds 1 million people - nearly a 40 percent increase over the level from FY 2008.

High Rate Claim Denial in Texas

In Texas at the initial claim level (the application), SSD and SSI claimants have been denied at the rate of 61.5%.

For those who were denied and chose to file appeals, Texas claimants were again denied at an even higher rate: 84.2%.

More initial claims are denied than are approved and an astoundingly high percentage of first appeals are likewise denied.

Steps to protect your Social Security Disability, Veteran's or Pension Benefits:

Do NOT commingle Social Security and exempt benefits with nonexempt funds.

Do NOT obtain a loan or credit card from the bank where your Social Security or pension is deposited. If sued, go to court and demand proof of the debt.

If your bank account is frozen, file an exemption claim within 10 days.

IRS and SSD

The IRS can take money each month from a Social Security disability check.

The practice is part of the agency's Federal Payment Levy Program, which allows up to 15 percent of any federal payments a delinquent taxpayer receives to go directly to the IRS until their overdue taxes are paid in full.

The IRS employs an automated levy system that withholds Social Security payments to taxpayers with incomes below the poverty line. If this is happening to you ... call.

Ask for a person -- not a computer -- to provide a review. You may be classified by the agency as unable to pay.

IRS Taxpayer Advocate: 1-877-777-4778

If your reasonable expenses are more than your income you may be eligible to have an IRS levy from your bank account refunded. The IRS will have a telephone interview with you to determine your ability to pay. This includes and discussion of your assets and resources. They will then ask for your monthly expenses. Typically you will have to fax the IRS your last three months of bank statements.

While the IRS has ten days to decide on a refund they actually can and usually do act more quickly. You bank may require 72 hours to restore your funds. In reality the IRS may act more quickly than your bank.

There is a possibility that you will have a partial restoration of funds rather than a full restoration.

A restoration of funds for hardship and a classification of 'unable to pay' does not mean your debt is forgiven. You will continue to owe your debt. However, your funds for living expenses may be partially or fully restored.

Posted by admin • July 15, 2009 • Printer-friendly

bluepill1 Getting Help with Prescriptions The number of people searching for prescription medicines that are no cost or free is rising daily.

One recent survey found one in five Americans have gone without their medications, split pills or skipped doses.

Most assistance programs have income limitationsbut several have eased eligibility requirements because of the recession, even though they've seen a surge in applicants.

Start with Your Physician

child25 Getting Help with Prescriptions The first step should be to tell your doctor you need help. He or she often can give you free samples provided by drug companies, although some doctors say that they're getting fewer samples now, just when they have more patients asking for them.

Google Search "Patient Assistance Programs"

A good next step is to do an Internet search for "patient assistance programs," or go to one of several Web sites sponsored by hospitals, consumer groups, drugmakers and others, that connect patients with individual assistance programs.

Websites for starters:

http://www.rxhope.com,
http://www.needymeds.org,
http://www.patientassistance.com,
http://www.patientadvocate.org
Pharmaceutical Sponsored Partnership for Prescription Assistance, at http://www.pparx.org.

You will find an online application, information about government and other assistance programs, a search function to find programs for specific drugs, and links to patient groups and other sites on diseases.

Together Rx Access has coupons for rebates or free samples. It supplies cards that people who don't have drug coverage and aren't eligible for Medicare can use in nearly all pharmacies to get discounts of 25-40 percent on prescriptions.

Patient Assistance Programs -- What to Do

Before applying, assemble the documents you likely will need to get approval for a patient assistance program:

Your last income tax return and, if you're employed, recent pay stubs.
If you're unemployed, a letter or other document from your former employer stating you have been terminated and your health insurance has been stopped.
Your last few months of bank statements.
Statements covering any investments you have.
Information on accumulated medical debt, which could affect eligibility.

Make sure you include all requested information to avoid being turned down and having to reapply, which could significantly delay help.

Do not accept rejection. Keep on trying!!! Explain your circumstances in greater detail if you are rejected.

Even if accepted reapply every year. That can cause a gap without the medicine, so don't wait until the last minute.

Besides helping get medications free from a manufacturer or charity, assistance programs often help patients get qualified for Medicaid, which covers poor and disabled people, or other government health programs.

The Patient Advocate Foundation

The Patient Advocate Foundation will appeal denials to try to reverse them, help people get Social Security disability income or Medicaid coverage, and get preauthorization for expensive medical care. It does so using case managers trained in the ins and outs of specific issues.

"For people that need case management to get resolution, 98 percent get what they need" or close to it, said the foundation's chief executive, Nancy Davenport-Ennis.

Even people with health insurance can sometimes find help, such as when they need medicines for cancer or other complex illnesses that can cost tens of thousands of dollars a year, or when they have special circumstances.

Patient Advocate Foundation can help you even if you have insurance.

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