If you have been diagnosed with a neurological condition or a mental health issue, your doctor has probably prescribed you some medication to help you manage your symptoms. These medications can be very expensive. Conditions like Tourettes, schizophrenia, depression, bipolar disorder, Alzheimer’s, dementia, or ADD/ADHD, can make it difficult to live life to your fullest potential. So how do you get the medication you need?
A FAMILIAR NAME
The answer is, of course, patient assistance programs like the one that Johnson & Johnson has. Johnson & Johnson is probably the most recognized name in pharmaceuticals. Today they are the focus of our article. We’re going to show you how to get enrolled in the Johnson & Johnson patient assistance program.
Johnson & Johnson’s patient assistance program is officially called the Johnson & Johnson Patient Assistance Foundation and their program is a little different from any others you might have encountered.
Some of the medications offered on the Johnson and Johnson Patient Assistance Foundation include:
Parafon Forte DSC
*Medications for Neurological conditions and mental health disorders are highlighted
DO YOU QUALIFY?
You should qualify for Johnson & Johnson Patient Assistance Foundation if:
· You are a U.S. citizen living in America, Puerto Rico or the U.S. Virgin Islands
· You are being treated as an outpatient by a licensed physician, and
· Your gross household income is less than 300% of the Federal Poverty Level.
PROVING YOUR INCOME
Once you have determined if your gross household income qualifies, Johnson & Johnson Patient Assistance Foundation requires your most recent 1040 (or tax transcript) to prove your income. If you didn’t file taxes last year, just check the box indicating that on the application and don’t worry about sending proof of income.
If your tax documents reflect an income higher the acceptable limit but your current income is within the guidelines, you can send a pre-appeal based on changed income. A pre-appeal is basically an explanation that you send before you expect a denial.
In this case, since you know you would be rejected based on the previous year’s income, you would send a letter explaining exactly how and when your income changed, in addition to the application and the tax documents. It is not required but you can also send in supporting documents, like an unemployment award letter, to reinforce your letter.
LOW INCOME SUBSIDY/EXTRA HELP
If your income is below 150% of the Federal Poverty Level, Johnson & Johnson will require that you apply for the Low Income Subsidy (also called Extra Help). They will enroll you in the Patient Assistance Foundation and provide you with medication for 120 days while you apply for the Low Income Subsidy. If you get enrolled on the Low Income Subsidy program, your medication should be covered by that program.
If you receive a denial letter, send a copy to Johnson & Johnson and they will continue your enrollment on their Patient Assistance Foundation. If it takes longer than 120 days to get a response from you, Johnson & Johnson will disenroll you from their Patient Assistance Foundation until you send them the Low Income Subsidy denial letter.
WHAT IF YOU HAVE INSURANCE?
If you have some kind of insurance, don’t let that keep you from applying. There is a segment on the application that asks you questions about your insurance; fill that portion out completely. Send in a copy of the front and back of your insurance card.
Also, don’t hesitate to write a pre-appeal letter explaining why you still need assistance with your medication and include any medical receipts or bills, including those for doctor visits, prescriptions, and medical equipment. Johnson & Johnson will take your financial hardship into account.
If you are eligible for Medicare but don’t receive it, neatly write “not receiving Medicare” next to the portion of the form that asks about Medicare.
Applications that show Medicare Part D will be denied initially. Don’t panic - resend the application, an appeal letter, and a pharmacy printout that proves that you need assistance. They look at these case-by-case so you have a good shot.
If they end up approving you with Medicare Part D, they will send you a certification letter that you are required to sign and return within 30 days. You will have temporary enrollment in those 30 days but, if you don’t send the form back with your signature, you will be disenrolled from the program.
MORE IMPORTANT INFORMATION
There are a couple of important notes to remember, based on where in the U.S. you live and what medication you are requesting:
If you live in Florida, make sure that your doctor’s address is already certified with Johnson & Johnson. If your doctor has other patients on this Patient Assistance Foundation, you shouldn’t have any problems but it’s best to check with Johnson & Johnson’s Specialty Distribution Services (800-652-6227). If your doctor is not listed with them, request that your doctor send a copy of their pedigree and state license to Johnson & Johnson as soon as possible. This must be done BEFORE you send your application.
If you live in one of the states that opted for the Medicaid expansion (Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Vermont, Washington or West Virginia), you will need to apply for Medicaid. The process is similar to the Low Income Subsidy process - you apply to Medicaid and if they accept you, your medication should be taken care of. If they send you a denial letter, mail a copy of the denial letter to Johnson & Johnson with your application.
If you live in a Non-Expanded state, you will only have to apply for Medicaid if your income is less than 100% of the Federal Poverty Level and if you are taking Invega, Invega Sustenna, or Risperdal Consta.
Now, you’ve got to fill out the application. Go to: http://www.jjpaf.org/resources/jjpaf-application.pdf to download an application. Now, take a deep breath, there’s just a little more to go.
HOW WILL YOU GET THE MEDICATION?
Your doctor has to fill out a portion of the Johnson & Johnson application too and there are some important points for them to consider. Depending on the medication, your doctor will have the option to request a pharmacy card to allow you to pick up your medication at a pharmacy or to have the medication send to their office. One medication, Imbruvica, can be sent directly to your home.
If your doctor selects the pharmacy card option, Johnson & Johnson will send you a pharmacy card for you take to your pharmacy, along with a prescription.
Your doctor must be very precise on the prescription; s/he should request one year’s worth of medication. S/he should request the medication by brand name - without a specific request for the brand name, you will be charged for the generic equivalent instead of receiving free medication.
For the medication to be sent to your doctor, s/he should take care to fill out the application accurately because it will act as the prescription. Your doctor’s office will need to request refills for your medication every 30, 60, or 90 days, depending on how the Johnson & Johnson is distributing it.
SENDING IN THE APPLICATION
Now that everything is filled out and your financial and insurance documents are all in order, you need to send in your entire application to:
MAIL: Johnson & Johnson Patient Assistance Foundation, Inc.
Patient Assistance Program
P.O. Box 221857
Charlotte, NC 28222-1857
There you have it. If you are enrolled in the Johnson & Johnson Patient Assistance Foundation, your enrollment lasts one year. About 30 days before the end of your enrollment, it will be time for you to re-enroll which is just like your initial enrollment. Call the Patient Assistance Foundation to make sure that nothing in their program has changed: 800-652-6227. It’s better to ask questions now than to have to learn the hard way after being denied.
If you need help getting enrolled in the Johnson & Johnson Patient Assistance Foundation, Prescription Lifeline can assist you! Contact Prescription Lifeline at www.PrescriptionLifeline.org or call and speak to a patient advocate at 1-888-331-1002. Whether you need help with prescriptions or you’re just curious about getting the best price for your Medicare coverage, Prescription Lifeline is here to help.