Financial Assistance Policy - Specialty Pharmacy

Purpose

To ensure that a systematic process exists for the provision of pharmacy services at a reduced rate to those patients who have documented limited resources to pay for their prescription drugs, co-payments, and pharmacy related deductibles as approved by Community Health Network (CHNw) by the CHNw Specialty Pharmacy. The program is available to patients that have inadequate prescription drug coverage, gaps in their insurance coverage, no prescription drug coverage, for patients with a household income at or below the federal poverty guidelines or who need financial assistance to obtain their prescription drugs (i.e., high co-pays), as defined and approved by CHNw for their family size (see policy). CHNw offers a multiple tiered discount program that may help patients receive their medications at a lower cost.

Policy

Specialty Pharmacy Financial Assistance Policy (PDF)

In recognizing the medical needs of the indigent, CHNw provides necessary quality medical care regardless of race, creed, color, sex, national origin, sexual orientation, physical abilities, age or ability to pay. CHNw offers many direct programs and collaboration with Jane Pauley Community Health Centers. CHNw recognizes its responsibility to the community by ensuring that patients requiring necessary medical care and prescription drugs are not denied services based solely on lack of financial means. The necessity for medical treatment of any patient will be based upon clinical judgment and could exclude all elective services without regard to the financial status of the patient. Although reimbursement for services rendered is critical to the operation and stability of CHNw, it is recognized that not all individuals possess the financial ability to purchase essential prescription drugs. Therefore, in keeping with CHNw’s commitment to serve all members of its community, CHNw has provided a multiple tiered charity program that will fit the needs of all situations where need and inability to pay co-exist. The pharmacy services provided will be reimbursed at a reduced level based on established income criteria as defined in this policy.