State Pharmaceutical Assistance Program: Vermont

Thousands of Medicare beneficiaries struggle between paying their monthly bills and paying for their medications. These beneficiaries struggle because they don’t have enough money in their monthly budget to pay for their medications and their bills. This is one of the hardest decisions that any family can make but it’s one that is made in families around the country every day.

Instead of ignoring the problem, there are some states that have accepted the challenge and are offering their residents help. The programs that are available to help are called state pharmaceutical assistance programs and are only open to those that meet certain eligibility requirements. While not all states offer these programs, those that do are able to provide residents a way to save money and maintain a comfortable standard of living. With the help of state pharmaceutical assistance programs, many residents don’t have to worry as much about being able to afford their medications.

Vermont is a state that offers their residents a state pharmaceutical assistance program.

VPham

VPham is the state pharmaceutical assistance program offered to the residents of Vermont. Those that are interested in the program can get more information by calling 800-250-8427.

Eligibility Requirements

For those that are interested in applying for this program, there are eligibility requirements that have to be met. The eligibility requirements are as follows:

  • Must be a resident of Vermont and a US citizen (resident aliens are also eligible as long as they are lawfully admitted)
  • Must be 65 years old or receiving disability benefits through the Social Security Administration
  • Must not be receiving prescription drug coverage from other programs except Medicare
  • Income must meet program restrictions: less than 150% VPharm 1, 175% VPharm 2 and 225% VPharm 3

Who to Contact

Those that meet the requirements and are interested in more information or applying, the following address is where inquiries should be forwarded:

312 Hurricane Lane

Suite 201

Williston, VT. 05495

What are the Benefits

Those that are approved for the program will receive the following benefits:

VPharm 1 Beneficiaries- These beneficiaries will pay a monthly premium but the program pays for the premium beneficiaries are responsible for up to a certain amount. Beneficiaries will also receive help paying for medication copays, co-insurance and deductibles they are responsible for that are covered by their prescription drug plan provider. Medications that are normally prohibited by a Medicare Part D prescription drug plan may be covered under the formulary approved by VPharm. These beneficiaries are also allowed 1 comprehensive and 1 interim exam every 2 years by an ophthalmologist or optometrist.

VPharm 2 Beneficiaries- These beneficiaries are expected to pay a monthly premium to receive help paying for their monthly Medicare Part D prescription drug plan premium up to a certain amount. These beneficiaries will also receive help paying for their copays, co-insurance, deductibles and coverage gap payments they are responsible for. These beneficiaries may also be able to receive help paying for medications that are not normally covered under their Medicare Part D prescription drug plan formulary.

VPharm 3 Beneficiaries- These beneficiaries are expected to pay a premium for their benefits. These benefits include help paying for the premium for their Medicare Part D prescription drug plan. These beneficiaries will also receive help paying for any copays, deductibles, co-insurance and coverage gap payments for medications through their Part D prescription drug plans. Beneficiaries may also be able to receive help paying for medications that are not always available through their Medicare Part D prescription drug plan formularies.

The copays for VPharm programs 1, 2 or 3 vary up to $2. The premiums for these programs vary from $15-30.

Each applicant will be evaluated and placed in the program their income allows. For specific benefits, VPharm will have to be contacted directly.

Mar. 20 14'
I just finished styduing what to do about Part D for next year. I found that the premiums have increased and when a low premium is offered the indidvidual drugs are priced higher. The price for insulin ranged from $20 per bottle to $83 per bottle. the price of lisinipril ranged from $.0 to $35 per prescription. The price for lipitor ranged from $28 per prescription to $87 per prescription. The cost for drugs for me ranged from approximately $1600 per year to $4000. per year. Obviously the $4000 plan did not want me as a customer. The three companies I compared were about the same cost but the cost was arrived at by low premiums and higher drug cost or high premiums and lower cost for the drugs. The three companies did not have a deductible or a doughnut hole and paid for generic drugs only and the cost of the drugs after I spent $2400 rose significantly. The only way that the drug plan can be fair is to have Congress fix the price of all the commonly used drugs and to place all of the drugs in tiers so that one company can not place insulin, for example, in tier one and the next company place it in tier two. The whole plan is bogus and poorly planned. I will say that the information is better this year but still confusing unless you are familiar with the terms and how to find the right place on the internet. I currently will re-enroll in the plan I had last year. We paid $383 per month for the drug plan and health insurance. We paid an additional $1319 for our share of the drug cost. We also paid medicare $160 per month and a dental insurance of $73 per month and had out of pocket expenses for my dental care of $2600 and my husbands dental cost were $4500 that we make $200 per month payments to the dentist. For 2007 the medical insurance cost will be lower $365. per month the dental insurance will be $77. per month and medicare will be more I think $83 per month. And we still have to pay another $100+ per month for drugs. If we each took the most inexpensive drug plan and switch medical insurance and add on the monthly cost for drugs not paid by the insurance we would have a cost of almost $7000 per year. (roughly $600 per month plus medicare and dental insurance) I just am thankful that we can pay for all this now but every other cost is rising. House insurance is higher, auto insurance is higher, real estate taxes are higher and heating, electrical and auto gas bills are higher. Eventually something will have to give and it will not be any of the above items as one can not afoord to be without insurance. My husband's hospital bill for esophogal cancer was over $100,000. last year. So the insurance is well worth it when you have a major problem. I am diabetic and my drug cost are high. Most insurance companies will pay for the insulin but not for the syringes one needs to get the insulin into the body at a cost of $25. per month. That is the problem letting insurance companies design the program was a big mistake! Congress needs to overhaul the whole program and make it simular to the medical supplement plan that came out in 1994. Ten plans and the insurance company had to decide what to charge for the plans. You decided what plan you wanted and went for the most inexpensive premium. If the drug cost were standardized and the tiers were standardized it would be much easier to select a plan that fit your needs.
May. 26 14'

Get in on the discussion!

Name
Email