Need Help with Prescription Drugs in Maine?

State-Sponsored Programs

Full MaineCare Benefits (formerly Medicaid)
This program provides the most comprehensive medical and drug coverage.  It serves people with the lowest incomes.  But more groups are becoming eligible all the time. 

Notice about "Prior Approval" for Certain Drugs In most cases, you will have to try a "preferred drug" before a more expensive drug can be prescribed. If you have problems getting a prescribed drug, talk to your doctor. If your doctor asks DHHS to approve a certain drug for you and you are denied, ask for help from the MaineCare Prescription Drugs Help Desk 1-888-445-0497. If you still aren't satisfied and have more questions, contact Pine Tree Legal. To view the list, go to MaineCare's Preferred Drug Lists page. From there you can link to different versions of the list, depending on what software is available to you. Get help with using the Excel version of the Preferred Drug List

For example, children can now qualify, even if their family income is up to 200% of the poverty level.  Women with cervical or breast cancer with incomes up to 250% of poverty level can qualify. The same 250% income cap applies to adults who test positive for HIV. For an overview, go to Maine's Medical Assistance Programs: Who's Covered and Who's Not (MEJP).

If your income is too high to get regular MaineCare, you can get it with a deductible. This MaineCare with a deductible is for people with large on-going medical bills. It can also be for those who have a large past medical bill or a big medical expense coming up, like an operation.
More Information:  MaineCare Deductible: How Does It Work?

Low Cost Drug Program
This program helps elderly and disabled people who cannot qualify for Full Maine Care Benefits (above). For more details, go to MEJP's page on Maine Low Cost Drug Program for the Elderly and Disabled.

Maine Rx Plus Program
After several stalled attempts, the Maine Rx Plus program has become a reality. In its first phase, during the second week in January 2004, DHS sent cards to 73,000 Maine residents who had participated in the now defunct Healthy Maine program. Others can apply for a card by calling 1-866-Rx Maine (1-866-796-2463) or 1-800-423-4331. And an online application form is now available.

The program provides discounts to people with incomes at or below 350 percent of the federal poverty level:

• $2,793 monthly income for an individual
• $3,745 monthly income for a family of 2
• $4,694 monthly income for a family of 3
• $5,646 monthly income for a family of 4

The discounts give 10-25% off brand names and 60% off of generics that are included on the MaineCare Preferred Drug List.

More than 100 pharmacies, including Shaw's and Hannaford, are carrying the discounts. However, Rite Aid, CVS, Community Pharmacies, and Wal-Mart, among others, were not participating as of January 2004. View 1/14/04 list of participating drug stores.

Medicare Prescription Drug Coverage - Part D

Avoid Medicare Part D Fraud This new prescription drug program does not start until January 1, 2006. No one can sign up until November 15, 2005. No one should share account numbers or Social Security Numbers with telemarketers or any others who call. Sign up is free. When in doubt, check it out. Call the elders hotline toll free 1-877-353-3771

Major changes are coming to this program, effective January 1, 2006. Starting November 15th, 2005 through May 15th, 2006, people with Medicare will be able to choose a Prescription Drug Plan.

Get the latest information on Medicare Part D for low-income Mainers from Legal Services for the Elderly and Maine Equal Justice.

MaineCare and Low-Cost Drug Program recipients must change to a Medicare drug plan. You will be assigned to a plan which may or may not be the best one for you. Get help with your questions from:
Pharmacy HelpDesk for MaineCare and DEL Members 1-866-796-2463 (TTY 1-800-423-4331)

Additional resources:

Maine DHHS posts basic information about this start-up period and where to get help with choosing a plan.

Medicare Rights Center posts useful, easy-to-read information.

Medicare-The Official U.S. Government Site for People with Medicare
Their phone number is 1-800-MEDICARE.

Local and Regional Health Centers

Community Health Centers
Located in 29 rural communities throughout the state, each center has its own guidelines for sliding fee scale.  The centers provide medical services and give out drug samples when available.  

B Street Health Center, Lewiston (sliding fee scale); Portland Street Clinic; Biddeford Free Clinic; Sanford Kiwanis Free Clinic; Leavitt's Mill Health Center, Buxton; Oasis Health Center, Brunswick; Ellsworth Free Clinic

CarePartners
This program operates in Cumberland, Kennebec, and Lincoln counties. It provides "managed healthcare and pharmaceutical coverage to people with limited income who cannot obtain insurance through their employers and are not eligible for government programs."

Lewiston Community Clinical Services Discount Drug Program
Patients of participating physicians are eligible for savings on brand-name prescription drugs. Sponsored by Community Clinical Services, which has 16 medical practices in the Androscoggin region.

Company-Sponsored Programs

Rx Cares for ME
You can search for drug company programs that offer certain drugs for free or at a reduced cost to people who qualify. The same search engine is offered on PhRMA's site: HelpingPatients.org

Several health-related state organizations endorse the site but the AARP criticizes it, stating that it's PhRMA's attempt to devalue the states' price-control initiatives. (Source: Portland Press Herald 7/22/03) If you find help on the site, you would still have to ask your doctor to request the drug for you from the manufacturer.

RxAssist/Rx Outreach
A program similar to PhRMA's HelpingPatients.org (see above). However, you can order the discounted drugs yourself, rather than having to rely on your doctor to order for you.

Together Rx Card
Sponsored by several major drug companies, provides financially-eligible seniors and disabled Medicare recipients with 20%-40% savings on approximately 150 medications.

Discount programs offered by specific companies (for Medicare recipients)

GlaxoSmithKline's Orange Card Program

LillyAnswers Card

Novartis Care Card

Pfizer helpful answers

More Resources

Maine Bureau of Elder and Adult Services On-Line Services

Drug Pricing Survey
Each year this state agency collects drug prices from all retail pharmacies in Maine, and some Canadian border and mail-order companies. Using this data, it posts a drug pricing calculator, to help you find the best prices in Maine for the drugs you need.

Medicare Savings Calculator
Many Medicare recipients are also eligible for some MaineCare coverages and don't know it. This calculator is designed to help you find out if you can get some of your health care costs covered by MaineCare. For example, MaineCare will pay the Medicare Part B premium for many people who are not currently getting this benefit. The application process is simple. Go to the calculator to find out more.

Prescription Drug Assistance: A Guide To Programs And Benefits
A very comprehensive resource guide, updated yearly. Includes many of the programs listed here, and more.

Consumer Reports Best Buy Drugs
Reports on common drugs, assessing effectiveness and cost comparisons.

Consumers for Affordable Health Care
Posts a lot of health care information for Maine people, including Prescription Drug Information and other free and low-cost health resources.

Tom Allen's Prescription Drugs Page
Congressman Allen lists more resources, including information about ordering drugs from Canada and a generic drug finder.

Buying Drugs Over the Internet
Health Canada explains how to protect yourself against fraudulent internet sales.

Department of Veteran Affairs, Health Administration Center
For veterans, their dependants, spouses and former spouses, and survivors, there are several programs including: TRICARE Senior Pharmacy, Veterans Pharmacy Services, and CHAMPVA for Life (CFL).

Notice © Pine Tree Legal  Assistance December 5, 2005 Sometimes the laws change. We cannot promise that this information is always up-to-date and correct.  If the date above is not this year, call us to see if there is an update. We provide this information as a public service.  It is not legal advice.  By sending you this information, we are not acting as your lawyer.  Always consult a lawyer, if you can, before taking legal action. Please review our full terms-of-use agreement

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