Greyson watches his budget very carefully. He has epilepsy and is no stranger to how expensive medications can be.
To help keep his costs down, he’s enrolled in a copay assistance program offered by the CARE Program, through Meritain Health Pharmacy Solutions. Because Greyson’s seizures are often very severe and he sometimes suffers from other health complications, he takes a few different medications to manage his condition.
Though these high-cost prescriptions are very effective at making him feel better, they quickly whittle away the maximum funds allowed for his copay assistance program. When this happens, he’s left to cover the costs out of his own pocket—which can run him close to $1,000 per month.
Luckily, since Meritain Health regularly reviews and analyzes member claims, they noticed Greyson was paying large amounts for his medication on an ongoing basis. His case was sent for a closer look, and a CARE specialist was assigned to see what they could do.
The CARE specialist knew Greyson could be at risk of going off his meds if he wasn’t able to afford them. Realizing this would jeopardize Greyson’s quality of life, her first move was to help Greyson enroll in a new copay assistance program. But unfortunately, this could only take care of covering $1,300 for the year. Since that would only go so far in helping, the CARE specialist researched further.
After lots (and lots) of digging, she found a patient assistance program to potentially fund a larger chunk of Greyson’s medication. The CARE specialist had him enroll for participation immediately—and he was approved!
Going one step further, she also contacted Greyson’s local pharmacy so his prescriptions could be filled closer to his home.
Because of the thoughtful and diligent work of his CARE specialist, Greyson will now be paying $0 out-of-pocket for his epilepsy medication for an entire year! And he’ll have the added convenience of using his local pharmacy.
Greyson knows his condition comes with its fair share of challenges. But he’s so relieved to have had the help of Meritain Health, and the CARE Program to make his life a little easier.
This story is based on an actual member experience. Names and information have been changed to protect the member’s privacy.
This communication is intended for informational, promotional purposes only. The reference to previous outcomes made as a part of this communication does not guarantee success or similar outcomes in any new or future cases, as the result of each case depends upon many factors, including but not limited to the facts of each case. Any actual savings will vary based upon numerous factors, and neither Meritain Health nor its affiliates guarantees any level of savings.