Nobody should have to
choose between
buying
groceries and paying
for their medications.
We
can help.
Are prescription drugs costing you
more
than
$
90 a month?
AmeriPlan
®
may be able to help!
AmeriPlan
®
now offers, to its members who qualify, the
AmeriPlan
®
Prescription Advocacy Program (APAP). APAP
provides an easy, affordable way to obtain
costly
prescription medications. We offer a low-cost,
worry-free,
full-service prescription assistance program
designed to
utilize Patient Assistance Programs (P.A.P.s)
currently
offered by pharmaceutical companies that provide
medications
to eligible individuals.
Traditionally, participation in a P.A.P.
requires a lengthy
qualification, application and approval
process for the
patient for each medication. Now, with the
AmeriPlan
®
Prescription Advocacy Program, we do all the
legwork for
you, allowing you to receive your medications at
substantial
savings ~ worry-free!
To get started, just verify your eligibility,
then fill out and
send in the attached APAP Member Application
including
your one-time enrollment fee and first month's
service fee, a
total of
$
$107. You will be charged
$82
monthly thereafter to participate in the
program. You
may cancel at any time.
What services does APAP
provide its Members?
· Determines initial eligibility
· Gathers all necessary documentation
(authorization forms, proof of income, etc.)
· Sends proper forms to prescribing
physician
for signature and additional information.
· Submits applications to appropriate
Patient
Assistance Programs.
· Automatically handles refills or
renewals to
continue your ongoing supply of
medication.
· Medications come in 90-day
supplies, and
usually ship in 6-8 weeks.
For more
information contact:
rescription
P
rogram
P
dvocacy
A
Teena
P
(877)290-2242 Toll Free
C L I E N T E X A M P L E # 1
MEDICATION DOSAGE/QUANTITY RETAIL
APAP
Advair
®
................ 250/50mcg/1 disc ..............
$
183 ............
$
0
Lipitor
®
................ 10 mg/30 tablets.
................
$
83 ............
$
0
Plavix
®
.................. 75 mg/30 tablets
..............
$
131 ............
$
0
Nexium
®
.............. 40 mg/30 tablets ..............
$
146 ............
$
0
Singulair
®
............ 10 mg/30 tablets. ..............
$
103 ............
$
0
Zoloft
®
.................. 25 mg/30 tablets
................
$
86 ............
$
0
Monthly fee
........................................................
$
0 ..........
$
82
TOTAL COST PER MONTH ..........................
$
732 ..........
$
82
CLIENT #1 REDUCED HIS TOTAL MONTHLY COST
BY
OVER 80%, SAVING HIM
$
650 PER MONTH.
WITH APAP, HE WILL SAVE OVER
$
7,800 PER YEAR!
C L I E N T E X A M P L E # 2
MEDICATION DOSAGE/QUANTITY RETAIL
APAP
Actos
®
.................. 30 mg/30 tablets
..............
$
186 ............
$
0
Celebrex
®
.......... 200 mg/30 tablets. ............
$
190 ............
$
0
Monthly fee
........................................................
$
0 ..........
$
82
TOTAL COST PER MONTH ..........................
$
376 ..........
$
82
CLIENT #2 REDUCED HER TOTAL MONTHLY COST
BY
OVER 78%, SAVING HER
$
294 PER MONTH.
WITH APAP, SHE WILL SAVE OVER
$
3,500 PER YEAR!
FOR MORE INFORMATION CONTACT:
Affordable, name-brand
medications are
just
3 steps away!
STEP 1:
A N N U A L I N C O M E Q U A L I F I C
AT I O N S
Use this chart to determine the income
eligibility
of yourself and/or your family.
PERSONS IN
MAXIMUM
FAMILY/HOUSEHOLD
INCOME
1
(Single)................................................
$
20,420
2 persons
..............................................
$
27,380
3 persons
..............................................
$
34,340
4 persons
..............................................
$
41,300
5 persons
..............................................
$
48,260
6 persons
..............................................
$
55,220
7 persons
..............................................
$
62,180
8 persons
..............................................
$
69,140
STEP 2:
R X C O V E R A G E S T A T U S
· No Rx coverage from an insurance
policy or
government assistance program
(e.g. Medicaid,
V.A., state assistance, etc.
)
· Rx benefit has been exhausted
·
Prescribed medication is specifically not covered
under Rx formulary
STEP 3:
M O N T H L Y F E E S
ONE-TIME
Sign-Up Fee....................................
$
25.00
Monthly Service Fee
......................................
$
82.00
$
25 Sign-Up fee and first month's service fee due
upon Sign-Up (
$
107.00)
APAP Applicants must be AmeriPlan
®
Members to receive the
discounted
$
82 per month service fee.
E X A M P L E S O F S AV I N G S E X P E R I E N
C E D B Y A PA P C L I E N T S
rescription
P
rogram
P
dvocacy
A
Name-Brand Medications, Substantial Savings
Teena P.
(877)290-2242