Note: Many people living with serious mental illness rely on Medicaid for their services, supports, and treatment. For others, access to treatment is a critical component of their health, a condition that may likely be compromised by Hurricanes Gustav and Ike.
HHS Provides Prescription Drug and Durable Medical Equipment Assistance for Uninsured
Louisiana Victims of Hurricane Gustav
HHS Secretary Mike Leavitt announced $1 million in individual assistance for Louisiana victims of Hurricane Gustav, through a new Emergency Prescription Assistance Program (EPAP) administrated by the Centers for Medicare and Medicaid Services (CMS). The program is an efficient way for pharmacies to process claims for prescription medications and certain durable medical equipment items for individuals who are without any form of health insurance and are from the Louisiana disaster area declared by the President.
Claims for individuals with private insurance, such as employer-sponsored coverage or an individual health insurance policy, are not eligible for payment under the EPAP. Nor are claims for individuals with public insurance, such as Medicare or Medicaid.
EPAP covers a one-time, 30-day supply of medications and certain durable medical equipment, such as canes, walkers, wheelchairs and diabetic supplies. With a written prescription, eligible individuals may receive assistance for essential pharmaceutical and durable medical equipment lost as a direct result of Gustav. The supply can be used to treat an acute condition and to replace maintenance prescription drugs or medical equipment.
For eligible individuals, the program also would cover, at no cost to the patient, replacements for needed drugs or equipment lost or damaged while in transit, such as from an emergency site to a designated shelter facility. To help determine eligibility, pharmacies must check at the point of sale for other forms of health insurance coverage. Only claims with a date of service between Sept. 2 and Sept. 11 are eligible under the EPAP-Gustav Activation at this time.
Eligible individuals must have a new prescription from a licensed health care practitioner, a current prescription bottle, a prescription phoned in by a licensed health care practitioner, or proof of an existing prescription in order to receive a prescription fill and/or certain durable medical equipment. Pharmacies must dispense the generic form of medication unless otherwise indicated as brand medically necessary by the licensed health care practitioner.
U.S. Department of Health & Human Services
Centers for Medicaire & Medicaid Services
What consumers and families need to know...
Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricanes Ike and Gustav, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred.
Crisis services provided to Medicare and Medicaid patients who have been transferred to facilities not certified to participate in the programs will be paid.
Medicare contractors may pay the costs of ambulance transfers of patients being evacuated from one health care facility to another.
Normal prior authorization and out-of-network requirements will also be waived for enrollees of Medicare, Medicaid, or SCHIP managed care programs.
Normal licensing requirements for doctors, nurses, and other health care professionals who cross state lines to provide emergency care in stricken areas will be waived as long as the provider is licensed in their home state.
Certain HIPPA privacy requirements will be waived so that health care providers can talk to family members about a patient's condition even if that patient is unable to grant that permission to the provider.
Hospitals and other facilities can be flexible in billing for beds that have been dedicated to other uses, for example, if a psychiatric unit bed is used for an acute care patient or vice versa.
Hospital emergency rooms will not be held liable under the Emergency Medical Treatment and Labor Act (EMTALA) for transferring patients to other facilities for assessment, if the original facility is in the area where a public health emergency has been declared.
Contact your insurance company or benefits manager as soon as possible and determine alternative arrangements for your care and service.
Contact the NAMI state organization in your relocated state for local resources and referrals to provider services that meet the needs of people living with serious mental illness.
If you are a Medicaid recipient who has evacuated to another state, your Medicaid benefits will still apply as long as you are treated by an out-of-state provider who is willing to accept your state's Medicaid as payment. For information on securing a transfer of this benefit, call and for pharmacy benefits related to Medicaid, call Texas 2-1-1 or (877) 541-7905.
If you routinely had your prescriptions filled by a national pharmacy chain (Walgreens, CVS, etc.) your information is in their system. You can go to any store and they will have your history and be able to assist with refills. Take your former prescription bottle to the pharmacy with you for assistance with a refill.
In the likely event that you do not have access to your regular doctor or clinic and you do not have any refills available, or you do not have access at all to your former medication, find a provider in your relocated area and schedule an appointment. If you have them, take your former prescription(s) with you to a new provider so he/she can have access to at least some of your treatment information. Having a family member or friend present, if possible, will also help to relay previous history to ensure best results.
For medical pharmacy program benefits, please go to a pharmacy that accepts Medicaid benefits with your Medicaid card and/or call Medicaid at the numbers listed above for information regarding temporary enrollment.
Louisiana Residents, Did You Know???
If you are a displaced resident of Louisiana, have your former prescription bottle, and are in need of mental health medications, please contact 1-225-922-2700 and/or read below for additional information.
If you are a Medicaid recipient and your medical provider is unsure of how to get your prescriptions filled in other areas, ask them to call 1-800-437-9101 (in Louisiana) or out of state at 1-225-342-9768.
People specifically looking for help with patients in nursing homes, hospitals who need to evacuate, or other care units...
Uninsured & Uninsurable Needing Meds, Did You Know???
In addition to pharmacy assistance programs through relief efforts, an additional option for medications, perhaps more long-term, is available through Together Rx Access.
Q. Who is eligible?
A. To be eligible for the Card, you must:
Not be eligible for Medicare
Have no public or private prescription drug coverage
Have household income equal to or less than $30,000 for a single person and $60,000 for a family of four (income eligibility adjusted for family size)**
Be a legal resident of the US or Puerto Rico
Q. How do I know if I'm eligible?
A. To find out if you're eligible for the Together Rx Access™ Card, please call 1-800-444-4106 or visit www.TogetherRxAccess.com. Together Rx Access also can help direct you to various resources for help on obtaining coverage or products.
Q. Which companies participate in Together Rx Access™?
A. Companies that participate with Together Rx Access™ include:
members of Johnson & Johnson Family of Companies ***
TAP Pharmaceutical Products Inc
Those Currently Receiving Medications
Patient Presceiption Drug Assistance Programs
Boehringer Ingelheim Pharmaceuticals, Inc.
Bristol-Myers Squibb Company
Eli Lilly and Company
Forest Pharmaceuticals, Inc.
IVAX Pharmaceuticals, Inc.
Janssen Pharmaceutica, Inc.
Ortho-McNeil Pharmaceutical, Inc.
To aid victims of Hurricanes Gustav and Ike who live with serious mental illnesses, NAMI has established the NAMI Hurricane Relief Fund. To make donations to this fund, visit www.nami.org/HurricaneRelief.
Join NAMI today!
When you become a member of NAMI, you become part of America's largest grassroots organization dedicated to improving the lives of persons living with serious mental illness. And now you can join online.