1. www.medassist.org

2. What is NC MedAssist? NC MedAssist is a charitable statewide pharmacy program created to assist uninsured and low-income North Carolinians gain access to prescription medications. Eligible applicants have the opportunity to obtain FREE brand name and generic prescription medications with the benefit of having their prescriptions mailed directly to their homes or to a local clinic or pharmacy for pick up.

3. www.medassist.org MedAssist of Mecklenburg MedAssist of Mecklenburg was incorporated in 1997, as a free pharmacy program to serve any uninsured, low-income senior adult in Mecklenburg County and is a member of NCAFC. In 2005, MedAssist expanded its program guidelines to include any Mecklenburg County resident of any age that is uninsured and low-income. Through a grant from the Attorney General’s Office, MedAssist expanded once again in 2009 to include eligible clients at the state level. Since expanding our services to the statewide level, NC MedAssist now provides life-saving medications to North Carolina citizens in 96 counties across the state.

4. www.medassist.org A unique pharmacy program NC MedAssist has partnered with seven major drug manufacturers to provide patients with medications by utilizing bulk replenishment programs. Currently contracted with Pfizer, Merck, AstraZeneca, Novartis, Eli Lilly, Abbott and Alcon. NC MedAssist dispenses the donated brand name (and generic medications) obtained by the pharmaceutical companies through a centralized location (NC MedAssist, Charlotte office). The patient or their provider completes the enrollment application and mails or faxes it to NC MedAssist. One application gives the client access to all of the branded and generic medications on our formulary.

5. www.medassist.org One Application = Generic Medications Astra Zeneca Eli Lilly Abbott Novartis Alcon Merck Pfizer

6. www.medassist.org NC MedAssist Eligibility Uninsured No other means for prescription medications such as: o Medicaid o Veterans Administration o Private Health Insurance Patients must have a Social Security number/w-7 to obtain branded medications. Low-income, under 200% of FPL o $22,340/year – individual o $46,100/year – family of 4

7. www.medassist.org Supporting Documentation Patients should be prepared to provide the following information to complete the enrollment application: Proof of North Carolina residency: Phone Bill, Lease Agreement or Utility Bill Written prescriptions from a medical provider, medical history and allergies Documents supporting proof of income- the following will be accepted: –Pay stubs from employer –Current year social security benefit letter –Notice of awards letter, with start date if on SS Disability –Most recent IRS Tax form 1040, including Schedule C, if self-employed

8. www.medassist.org Safety-Net Partners NC MedAssist has developed a network of over 60 safety-net partners throughout the state to assist in enrolling patients into the program. Those agencies are comprised of Free Clinics, FQHC’s, Health Departments, DSS facilities, Community resource centers, CCNC networks and Hospital outpatient pharmacies. Point of Entry: –The Point of Entry assists the patient in the enrollment process –The medication is sent to the facility (must have a licensed pharmacy and be classified as a non-profit facility) Enrollment Site: –The enrollment site simply assists the patient in the enrollment process –The medication is sent directly to the patients’ home

10. www.medassist.org NC MedAssist Workflow: Patient process Step 1 Patient obtains a prescription for medication(s) that are available on the NC MedAssist formulary Step 2 Patient or patient advocate completes the enrollment application and faxes or mails it, along with the supporting financial documents to NC MedAssist. The application can be found on the NC MedAssist website or on the MARP (Medication Access and Review Program) software system Step 3 NC MedAssist Customer Service Representatives (CSR) review the application, prescriptions and supporting documentation to verify patient’s eligibility CSR will call the patient if any additional information is needed Step 4 Once the patient is enrolled into the program the pharmacy fills the prescriptions and sends the medication directly to the patient or the clinic partner. Patient or clinic partner can expect to receive the medication 3-5 days after enrollment process is complete.

11. www.medassist.org NC MedAssist Workflow continued… Medication comes pre-packaged, labeled and ready to dispense directly to the patient. Branded medications are provided in a 30 day initial supply and 90 day refills. Generic medications are provided in 90 day supply (with the exception of mental health medications, which are provided in a 30 day supply). Refills do not require additional paperwork and can simply be placed by using the automated phone system (the patient or patient advocate can call in the refill). Enrollment is active for one year, and there is no limit to the number of prescriptions a client can receive.

12. www.medassist.org Who helps the patient enroll? In the hospital setting, the following employees can assist the patient in the enrollment process: Case Managers Financial counselors Discharge planners The medication can be sent to the hospital outpatient pharmacy or directly to the patients’ home. Educating the prescribing staff on the NC MedAssist formulary is a critical component of successfully implementing the program in the hospital setting.

13. www.medassist.org A collaboration with NC MedAssist provides the following benefits: Decreases the likelihood of readmissions to the hospital Increases the overall efficiency of pharmaceutical care for the uninsured Increases likelihood of compliance by delivering right to their home Reduces staff time keeping track of individual patient assistant applications. Reduces pharmacists time in checking and labeling Increases the agency’s capacity to serve more people

14. www.medassist.org Chatham Cares Community Pharmacy Siler City, NC Chatham Cares Community Pharmacy is a private, volunteer-based, non profit organization that provides prescription drug assistance to residents of Chatham County. Jack Brooks, Rph Patricia Dowdy chathamcares@embarqmail.com 919-663-0177

15. www.medassist.org New Hanover Regional Medical Center “NC MedAssist has supplied many of our patients with generic medication assistance that would have otherwise been unavailable. This program has kept our patients from having to decide between spending $10 on a medication or putting food on their table.” Nicole Jenson, Support Associate at NHRMC

16. www.medassist.org NC MedAssist Cost Avoidance for access to and compliance with medication

17. www.medassist.org Growth FY 2007 – 2012

18. www.medassist.org The Affordable Care Act and its Future Effect on Patient Assistance Plans Medicaid Eligibility (2014) –The June 2012 Supreme Court decision made expanding Medicaid optional. –North Carolina will not be expanding Medicaid –50% of current clients at or below 138% of Federal Poverty Level $15,414.60 annually for an individual or $31,809.00 for a family of four ACA allows for people to opt-out –If premiums are greater than 8% of a person’s gross income; people are not held to the mandate –For people with income 139% - 200% - health insurance premiums would need to be less than $149/mo.

19. www.medassist.org The Affordable Care Act and its Future Effect on Patient Assistance Plans Con’t…. Because there will still be uninsured people, our pharmaceutical partners understand there will still be a need. Based on what we are hearing from national advocates they are looking to amend program guidelines to include underinsured patients in the programs. There continues to be a need for Prescription assistance for the low-income uninsured residents of North Carolina.

20. www.medassist.org “I sat down and cried when I found out I could get my medicines from MedAssist. It was such a weight off my shoulders that I wasn’t going to have to choose anymore between heat or food or medicine. Now I can sleep at night. I feel so much better, physically and mentally” - Mike picking up $1,800/mo in medication

21. www.medassist.org Questions? Jennifer Teague, Clinic Relations Manager (866)331-1348 x1732 jteague@medassist.org