Now that the initial enrollment period for health care is over, it's time to sift through the data and get ready for the next enrollment period.
Feb. 04-- When Patsy Haney's state-provided health insurance plan restricted its coverage, the cost of prescriptions forced the Fairmont City woman to choose between medicine to ease muscle spasms or another to fight drowsiness in her struggle with multiple sclerosis. For help, Haney and other residents turned to a prescription discount program began 10...
Feb. 04--When Patsy Haney's state-provided health insurance plan restricted its coverage, the cost of prescriptions forced the Fairmont City woman to choose between medicine to ease muscle spasms or another to fight drowsiness in her struggle with multiple sclerosis.
"It gets to the point where you ask 'Do I really need this medicine or do I stop taking it and hope for the best?'" Haney said. "You just can't afford the medicine anymore."
For help, Haney and other residents turned to a prescription discount program began 10 months ago in St. Clair County. Since then, the program has saved residents nearly $600,000 off the cost of prescriptions and other claims.
While there are no prerequisites to participate in the ProAct Prescription Discount Card Program, the program intends to help low-income residents without insurance or who are under-insured. Nearly 28,800 people in St. Clair County do not have health insurance, according to the most recent findings of the U.S. Census Bureau.
The card cannot be used in conjunction with other medical coverage. It benefits those paying out of pocket for medication and covers all brand name and generic drugs. Discounts are also available on vision, Lasik, hearing services, even to purchase medication for pets.
The county partnered with health care company ProAct Inc., based in East Syracuse, N.Y., in March 2012. Since then local residents have filled more than 16,000 prescriptions by presenting the card to pharmacies such as CVS, Walgreens, Target and Walmart. There is no cost for the county to participate in the program.
Haney said such programs were crucial for her and others because the state limited its coverage to only four of her 15 medications.
"If you have a disease like MS for 22 years, how does the state expect you to be cut off of all but four medicines?" she asked. "Obviously, you needed it otherwise doctors wouldn't have given it to you to begin with. ... They've thrown us to the side."
Local residents saved on average more than $36 per prescription, for a combined savings of $594,000. The savings vary depending on the claim. For example, residents in Fountain County, Ind., saved an average of 48 percent on each claim while those in St. Clair County saved an average of 59 percent per claim in the same time period.
ProAct account executive Karin Eckdahl said the program has "really taken off" in St. Clair County because the company mailed discount cards to about 103,000 households.
"It really does help with residents paying for prescriptions out of pocket," Eckdahl said. "The savings are quite significant."
ProAct benefits from the program through a transaction fee on each claim and introducing the company's other services to potential customers.
"There is a minimal transaction fee on each claim," Eckdahl said. "ProAct paid to have the card sent out to all county residents. So really what happens is we paid for that postage and it takes awhile to recoup the postage fee. Another side of our business is to administer pharmacy benefits on behalf of employers."
County Board Chairman Mark Kern said the program has succeeded beyond expectation.
"For residents who lack full prescription coverage or for those who have no coverage at all, a trip to the pharmacy can be very costly," Kern said. "By taking advantage of this cost-free program residents can see sizable savings on each of the prescriptions that they fill."
Eckdahl said the program also helps those with medical insurance whose coverage excludes some medications.
The program is growing with additional counties joining the program each month, Eckdahl said.
ProAct has added five states and 25 counties to its roster since the program began in St. Clair County. The program is now available in 12 states and 90 counties.
St. Clair County is the only Illinois county to take part in the program but that could change soon, Eckdahl said.
"We're expanding the program within the state of Illinois and hope to take on several new counties in 2013," Eckdahl said.
St. Clair County residents can use the card at any of the 65,000 participating pharmacies nationwide, Eckdahl said.
Contact reporter Daniel Kelley at firstname.lastname@example.org or 618-239-2501.
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