CAP Rx Discount Card Presentation

A free resource to help your un-insured and under-insured patients save money on their

prescription medications.

Community Assistance ProgramMaking healthcare more affordable

Savings

[email protected]

www.facebook.com/communityassistanceprogram

Topics explained in this Slide Presentation: Explanation of an Rx savings card - Slides 3 & 4

How discounts are created on Rx at local pharmacies - Slides 5 - 9

Explanation of the Community Assistant Program (CAP) outreach effort - Slides 10 & 11

Commonly asked questions - Slides 12 - 26

Additional Tools:

How to use the Pharmacy & Rx pricing lookup tools - Slides 27 - 34

Languages available for the Rx savings card - Slide 35

Other resources provided through CAP: Rx Med Assist (a Prescription Assistance Program) - Slides 37 & 38

CAP Diabetic Program (diabetic testing supplies) - Slides 39 - 40

Contact information - Slide 41

What is a Prescription Drug Discount Card?

A resource for people who are under-insured or un-insured to help them save on their prescription medications at their local pharmacy.

A resource designed to providequick and easy access to moreaffordable prescription drug pricing.

How are the Discounts Established With an Rx Savings Card?

The vast majority of pharmacies nationwide contract with Pharmacy Benefit Mangers (PBMs) to establish pricing structures on medications for health care plans.

For non-insurance Rx savings cards, discounted pricing for name-brand and generic medications are established in this same way to help un-insured and under-insured consumers more affordably fill their medications.

Pharmacies benefit from this collaboration through increased store foot traffic, enhanced customer loyalty and added sales of pharmacy & non-pharmacy goods and services.

A few things to know…

Roughly 70% of the three billion prescriptions filled each year in the US are handled through Pharmacy Benefit Managers (PBMs).*

PBMs handle pharmacy benefits for nearly 200 million Americans including 65% of the country’s seniors.*

* Source: Report to the FTC; “PBMs: The Basics and an Industry Overview” – The Health Strategies Consultancy, LLC 2003

Pharmacy Benefit Manager (PBM) Relationships

RetailPharmacies

Health Plan/InsuranceCompany

Employer/Plan Sponsor

PharmaManufacturer

PBM

This diagram (Figure 1) illustrates the various connections PBMs have throughout the health care industry.

Source: Report to the FTC; “PBMs: The Basics and an Industry Overview” – The Health Strategies Consultancy, LLC 2003

Figure 1

HealthTrans® , a Leading PBM Allowing Access to Rx Savings Card Discounts

One of the largest, most established PBMs is HealthTrans®. (see Figure 2)

HealthTrans has an A+ rating with the Better Business Bureau.

HealthTrans® is the PBM for the discount Rx savings cards we mail to you as a part of a grassroots outreach effort (Community Assistance Program (CAP)) to help people who are un-insured and under-insured.

RetailPharmacies



PharmaManufacturer

HealthTrans®(PBM)

Figure 2. illustrates HealthTrans’ relationship to the CAP grassroots outreach effort to

help people receive discounts on their Rx meds.

HealthTrans® (PBM), Pharmacies, and the Discount Rx Savings Card Provided Through the CAP Outreach Effort

RetailPharmacies



PharmaManufacturer

HealthTrans®(PBM)

Outreach Effort-Providing this resource

to hospitals, clinics, non-profit orgs., etc.

Figure 3 illustrates the relationship between HealthTrans® and retail pharmacies to show how they relate to the CAP outreach effort.

The CAP outreach effort provides the discount Rx savings cards to health care organizations* who are on the front-lines of helping people who are un-insured and under-insured.

* hospitals, clinics, emergency departments, urgent care facilities, mental health organizations, and community non-profits.

Source: Report to the FTC; “PBMs: The Basics and an Industry Overview” – The Health Strategies Consultancy, LLC 2003

Individualwith Rx card tofill prescription

Figure 3

In the Beginning…

Affordable Access Health Care Organizations (AAHCO) have long existed to offer an affordable alternative to insurance.

AAHCOs network with doctors and dentists to establish non-insurance reduced fee-for-service plans.

These plans are less costly than traditional insurance (but less comprehensive) and can offer a viable solution to the un-insured and under-insured who are challenged with obtaining or affording traditional insurance coverage.

Affordable Access Health Care Organizations

(Discount fee-for-service plansfor un-insured & under-insured)Discount medical

plans with

discount Rx medications

Discount dentalplans with

discount Rx medications

A Helpful Resource During Good Times and Bad

With the economic downturn, the need for assistance rose significantly for people who lost their employer-sponsored health coverage when they were laid off or couldn’t find employment. Private coverage was often too expensive and many employers reduced or eliminated employee health coverage due to rising premiums, etc.

A few of the AAHCOs realized that the prescription savings resource they provide to their fee-for-service plan clients could easily be made available, without cost, to people who were un-insured and under-insured—independently of the medical or dental reduced fee-for-service plans.

Since offering the Rx savings card resource for free didn’t require added cost to the AAHCOs, nor any paperwork, enrollment or qualifications on the part of the card holder, it made sense to make this prescription resource available, at no cost, to people who are un-insured and under-insured. This inspired the establishment of the Community Assistance Program, a collaborative grassroots outreach effort to help people access their medications more affordably.

Affordable Access Health Care Organizations

(Discount fee-for-service plansfor uninsured & under-insured)

Discount dental & medicalplans withdiscount

Rx medications(Free Rx savings card)

Community Assistance Program:

Outreach effort providing this resource to

hospitals, clinics, non-profit orgs., etc.

Figure 4. illustrates the evolution of the Rx savings card and outreach effort.

Discount Rx Medications

What is the “Community Assistance Program”?

Community Assistance Program (CAP) is the name of the grassroots outreach effort to provide the Rx discount resource to hospitals, clinics andother health care-related groups.

This outreach effort grew it’s legs at the beginning of the economicdownturn with the specific intention of offering these prescription savingscards to medical professionals on the front-lines of helping people in need including:

Case Managers Social Workers Clinics Emergency Department Mental Health Facilities Non-profit Organizations

Rx

Community Assistance Program (CAP) Further Explained

CAP is a collaborative effort between various groups dedicated to affordable access to healthcare.

Because CAP collaborators already offer the HealthTrans® Rx savings card to their medical and dental reduced fee-for-service clients, there is no additional cost—other than postage—for them to provide this helpful prescription resource to your organization.

CAP is a way for these healthcare access groups to lend their support to people who are un-insured and under-insured.

Providing the HealthTrans® Rx savings card resource to the people you serve does not promote or endorse any of the organizations involved in this grassroots outreach effort.

Commonly Asked Questions Related to CAP, the Rx savings

Card, and HealthTrans®

Q: Is the Community Assistance Program a “program” that we have to enroll in? Are we required to do anything when we receive the Rx savings cards?

Community Assistance Program is just the name of the outreach effort. It is not a formal “program” that requires sign-ups, qualifications, or paperwork.

This applies to both the organization receiving the cards and the individual card user. The Rx savings cards are ready for immediate use at most pharmacies nationwide.

An organization such as a hospital or clinic receiving the cards are not required to do anything when distributing the resource.

Although we hope you take advantage of this valuable resource, it’s purely voluntary for you to provide the Rx savings cards to people in need.

A: There are no enrollment requirements in order to recieve, utilize, and benefit from the Rx savings cards.

Q: Should we be aware of any promotion or endorsement of a vendor, company or pharmacy when providing these

Rx savings cards to the community we serve?

Note the HealthTrans logo on the front of the CAP Rx savings card:

This logo is needed to assist the pharmacy so they know what appropriate discount to apply.

As noted on previous slides, HealthTrans® is the pharmacy benefit manager for the Rx savings cards used in this outreach effort.

HealthTrans® has a solid reputation, with the highest rating with the BBB* and an extensive network of pharmacies that they are contracted with. This enables them to establish discounts on meds that are higher than average drug pricing discounts.

A: With this Rx savings card there is no promotion or endorsement of any organization, company or pharmacy when providing it to those in need.

* www.bbb.org/denver/business-reviews/health-care-management/healthtrans-in-greenwood-village-co-90020054

Q: Who are you providing these Rx savings cards to as a part of the CAP outreach effort?

A: There many types of organizations that have expressed the need for the Rx savings card to help those they serve. These include:

Hospitals Community Centers Clinics Religious Groups

PCPs Weight Loss Clinics Mental Health Facilities Assisted Living Facilities

Here’s a list of a few organizations actively providing the CAP Rx discount card to their patients:

• The USDA • Bright Star Missionary Baptist Church• InsureEasyLife.com • Forgotten Harvest • LUPE • Bayada Nurses Home Care Specialists• General Federation of Women’s Clubs • All Medical Resource Foundation, I• New Jersey Chamber of Commerce • International Technologies Medical Lab Svcs.• C.A.L.I.F. (Community Actively Living Independent & Free)

Q: What kind of savings do people experience when they use the CAP/HealthTrans® Rx savings card?

A: When someone with a valid prescription presents the HealthTrans® Rx savings card at a participating pharmacy, they can save on average:

15% on Brand Name Drugs

55% on Generic Drugs

Savings range from 10% to 85% off all prescription drugs.

The card can be used over and over again and it never expires.

Note: Privacy of card user is protected and no personal information is gathered at time of use.

Q: Is there a cost to get this resource for our organization?

A: There is no cost to receive the CAP Rx savings cards.

Through a grassroots outreach effort called Community Assistance Program, we have the ability to provide this resource to your organization for free.

Q: After we run out of our first batch of Rx savings cards, can we continue to request more from you?

A: Absolutely! Our goal is to provide this resource to any organization that has a need for it on an ongoing basis.

Feel free to request additional Rx savings cards at any time.

Other translations of the Rx savings cards are available. (see slide #32)

Q: What prescription drugs can a person get discounts on using the Rx Savings Card?

A: All FDA approved prescription drugs are eligible for a discount with the Rx savings cards—name-brand and generic.

Smoking cessation meds, psychotropic meds and diabetes supplies can also be obtained at greatly reduced rates.

Q: Does it cost a card holder anything to use the Rx savings card at a pharmacy and receive discounts on prescription medications?

A: The Rx savings card is free to use at any participating pharmacy.

Note: Multiple medications can be filled at the same time using one Rx savings card and it can be used over and over without expiration.

The card user is responsible for paying the discounted price of the prescription medication(s) once the card has been presented.

Q: Is the number of pharmacies that accept the Rx savings card limited?

Many well-known pharmacies that participate are:CVS • Walgreens • Rite-Aid • Wal-Mart • Target • Kroger

K-Mart • Longs Drugs • Safeway • Osco • Sav-On • Ongs Albertsons Sam’s • Winn-Dixie • Costco • Brooks • Stop & Shop • Medicine Shoppe Duane-Reade • Heb • Meijer • Hy-Vee • Giant • Raley's • Shopko • Bi-Lo

Smiths • Pathmark Fred Meyer • Aurora • Pamida • Fry's • Kings ShopRite • Hannaford • Tops • Weiss • and many more...

* Many local independent pharmacies accept the card too.

Simply go to: www.USMedSavings.org to find a participating pharmacy in your area.

A: Not at all. Over 80% of pharmacies nationwide and US territories accept the HealthTrans® Rx savings card.

Q: Is there any paperwork or pre-qualifications in order for someone to use the Rx savings card?

A: Absolutely None The Rx savings card is a “bearer card” meaning anyone presenting the card at a participating pharmacy can receive a savings.

Additionally, there is no gathering of any personal information at time of use—not even the person’s name.

Q: Will a discount be given every time the Rx savings card is used?

A: A person using the card will get a discount approximately 94% of the time.

The reason it is not 100% of the time is that, from time to time, pharmacies price certain drugs at “cost” to attract customers to their stores.

In this type of situation the cardholder would get the lowest price.

Average Savings: 15% on Brand Name and 55% on Generics.

Q: How will the Rx savings card holder know if they’re getting a discount?

A: An Rx savings card user can go to www.USMedSavings.org and look up what the price of their drug is at their local pharmacy. (see slide #27 of this presentation)

-or-The Rx savings card user can ask the pharmacist at the time of purchase how much of a discount they received using the card.

An entire household can use one Rx savings card. The card can be used over and over again & does not expire.

Q: Can the HealthTrans®/CAP Rx savings card be used with insurance?

Limited Formularies – Insurance companies are increasingly limiting which drugs they will pay for. The Rx savings card can be used to receive a discount when a medication is not covered. For example: birth control, diabetic supplies, smoking cessation, and other types of drugs that the insurance company decides are not cost effective for them.

High deductible plans – The Rx savings card can help people reduce the cost of their Rx meds while they are within their plan’s deductible limit and are required to pay 100% out-of-pocket for their prescriptions.

A: Yes and No. If someone has Rx insurance, but their medication falls outside of what’s covered by their Rx insurance formulary, then the Rx savings can be used. However, it cannot be used to receive a discount on an insurance co-pay.

Here are some situations where the card can be used alongside Insurance:

Q: Can someone use the Rx savings card even if they have Medicare or Medicaid (Medi-Cal)?

Medicare – The Rx card can be used when someone has Medicare, but is not enrolled in the Part D prescription coverage plan.

Medicare Part D – The Rx savings card can be used to secure discounts onthose drugs that are excluded from Medicare Part D. It will also provide discountswhen a person on Medicare reaches the “donut hole coverage gap”.

Excluded coverage for medications treating certain conditions under MedicarePart D: Anorexia, weight loss, weight gain, fertility, hair growth, supplemental relief of cough, Rx vitamins, and sleep aids.

Medicaid and Medi-Cal – The Rx card can be used when a medication falls outside of the set formulary under these programs.

An increasing number of people are experiencing this problem due to recent cutbacks in these programs at the state level.

A: Yes, the Rx card can be used alongside these plans. For example:

Additional tools to help your patients

To locate pharmacies that accept the Rx Savings Card, follow these steps:

1. www.USMedSavings.org (Must type into address bar at top of screen)

2. Click on the Drug Pricing & Pharmacy Look Up link button on the Home Page.

3. Click on Pharmacy Locator as shown here:

(Chose “By Distance…” or “By Pharmacy” then enter city, state, zip code and distance of the pharmacies you wish to search as shown below and click the “Go”

button)

You will come to a web site similar to the image below…

(Go to following slide for search results)

Search results of pharmacies that accept the Rx savings card within a specific city.

To price the discounts on medications using the Rx savings card, follow these steps:

1. www.USMedSavings.org (Must type into address bar at top of screen)

2. Click on the Drug Pricing & Pharmacy Look Up link button on the Home Page.

3. Click on Rx Drug Pricing as shown here:

You will come to a website similar to the image below…

(Enter the name of the medication in the “Drug Name” box as shown below and click the “Go” button)

(Go to following slide for search results)

Pricing the discounts on medications using the Rx savings card, continued…

1. Click the circle left of on Rx dosage you wish to price (see ).

(See following slide for additional steps)

2. After choosing Rx dosage wait a few seconds for the script details to appear as shown below and enter info.

3. Click the “Price Drug” box to price the prescription med.

(See following slide for pricing results)

Example, here are the pricing results for name-brand Zocor and its generic version, Simvastatin using the HealthTrans®/CAP Rx savings card at

Walgreens Pharmacy in the 78205 zip code:

Here are pricing results for name-brand Zocor and its generic version, Simvastatin using the HealthTrans®/CAP Rx savings

card at various pharmacies in the 78205 zip code:

CVS Pharmacy343 W Houston StSan Antonio, TX

Zocor 40 Mg Tablet 30 tablets: $164.68Simvastatin 40 Mg Tablet 30 tablets: $53.20

Trinity Rx #3700 S Saint Marys StSan Antonio, TX



M and S Tower Pharmacy730 N Main AveSan Antonio, TX

NOTE: This price comparison is not an endorsement of one pharmacy over another, it’s just an example of how the Rx Pricing tool can really help your

patients save even more. We appreciate how busy you are. These are just tools that you can use at your discretion.

The Rx savings cards can be translated in other languages!

Arabic • Armenian • Farsi • Hmong • Khmer • Korean • Mandarin • Russian • Somali • Spanish • Tagalog • Vietnamese

A: There are TWO supplemental programs available:

1) A prescription assistance program called Rx Med Assist that can reduce the price of expensive prescription medications.

2) CAP Diabetic Program to reduce the cost of testing supplies for diabetics.

Q: Are there other resources available through CAP?

What is Rx Med Assist?Rx Med Assist is a Prescription Assistance Program (PAP). PAPs date back to the 1950s when the U.S. government created incentives for pharmaceutical companies to help uninsured and under-insured Americans receive low-cost or free prescription drugs.

While PAPs are run by pharmaceutical companies, without a resource like Rx Med Assist, the enrollment process can be complicated and overwhelming to patients.

Rx Med Assist simplifies the enrollment process for people who have no public or private prescription drug coverage and struggle to pay for their monthly maintenance medications

How does Rx Med Assist help patients? Informs and educates patients about the options that best fit their needs.

Accesses, completes and processes all required forms.

Reviews over 250 programs that may help the patient save on their prescription meds.

Handles all annual reapplications for the patient.

If patient is eligible, the cost of each qualifying medication is reduced to $20 per month.

What guidelines must be met in order to quality for Rx Med Assist?

Medication must be offered through a Prescription Assistance Program (PAP).

Income eligibility guidelines apply depending on total family members (see chart).

Applicant cannot be covered by private prescription coverage, Medicare Part-D, or Medicaid (Medi-Cal). (some exceptions may apply)

Family Size Annual Gross Family

Income Limits

1 $27,225

2 $36,775

3 $46,325

4 $55,875

5 $65,425

6 $74,975

7 $84,525

8 $94,075

For each additional $9,350 family member

Annual Income Eligibility Guidelines for 2012:

Please call us at 866-889-1662 to learn more about the program - or - visit www.usmedassist.org for additional information or to

submit an application.

What is the CAP Diabetic Program?

CAP Diabetic Program is a supplemental resource provided through theCommunity Assistance Program (CAP) for discounted diabetic testingsupplies (mail-order) for the uninsured and under-insured.

The savings through the program average 50% off retail, over-the-counterpricing of diabetic testing supplies received through mail-order.

Monthly retail pricing for test strips: • $29.99 test once daily • $41.99 test 2 times daily • $43.99 test 3 times daily • $56.99 test 4 times daily • $58.99 test 5 times daily • $69.99 test 6 times daily • $78.99 test 7 times daily • $86.99 test 8 times daily • $94.99 test 9 times daily

The program includes the following: Free glucose meter Free lancing device Free monthly ultra-thin lancets Free carrying case Free monthly shipping Free Rx discounts (provided through the CAP Rx savings card)

How do you enroll in the CAP Diabetic Program?There are three easy ways to enroll:

1. Complete the easy online form at www.CAPDiabeticProgram.org and submit it electronically.

2. Call 1-888-983-7829 & mention group ID 1117 to speak with a friendly customer representative who will assist you with enrollment.

3. Go to www.CAPDiabeticProgram.org and print an enrollment form to fax or mail in.

Frequently asked questions:How does the program work?Upon enrollment, you will be electronically debited monthly from your checking account or credit card for everything you need to test your blood glucose levels monthly. Supplies will be shipped right to your door.

Are there any upfront fees, cancellation fees or long-term contracts?No, the program is month-to-month and you can cancel at any time without penalty.

Call us if you have any questions about this program: 866-889-1662

Please call or email us if you have any questions or if you would like to receive a free supply of Rx savings cards

for your organization.

1-866-889-1662 www.USMedSavings.org [email protected]

Community Assistance ProgramMaking healthcare more affordable

www.facebook.com/communityassistanceprogram

CAP Rx Discount Card Presentation

Health & Medicine