BREATH

 

 

Apply Here!

To download a paper application, click here.

Bridging Resources to Encourage Asthma Treatment and Health, or BREATH,  is a comprehensive asthma and allergy management program available to eligible children/young adults who have been diagnosed with asthma and/or allergies of all types.  This program was formerly called Project Concern.  Resources available through the program include:

Eligibility
BREATH serves children and young adults who either:

  1. Have no insurance and are in the process of applying for MO Medicaid, MO HealthNet for Kids, Illinois All Kids or Kids Care and are waiting for coverage to become effective; OR
  2. Have insurance, but are  in need of assistance with prescription co-pays AND
  • have been diagnosed with asthma or allergies
  • are under the age of 22
  • come from families that fall within 200% of the Federal Poverty Level, based on family size
  • live in one of the following Missouri or Illinois counties:  St. Louis City (MO), St. Louis County (MO), Jefferson (MO), St. Charles(MO), Madison (IL) or St. Clair (IL)

AAFA-STL grants assistance on a first-come, first-served basis to the extent that funding is available.  The AAFA-STL board of directors sets the eligibility criteria and has final determination in all cases.

How does BREATH Work?
BREATH serves Copay (with insurance) and Full-pay clients (no insurance), as well as clients who need resources not covered under their existing healthcare plans (like Medicaid).

  • Full-Pay clients are covered for 3 months, until a financial limit of $925 is reached or until they are enrolled in health care coverage, whichever comes first.  AAFA-STL is not a long-term solution for those without insurance.  Rather AAFA-STL serves as a stop-gap for people in need of their asthma/allergy medicines while they apply for and secure additional coverage.  All full-pay clients are required to apply to MOHealthNet/Medicaid/IL All Kids.  If full-pay clients are not eligible for Medicaid, they must apply to get their medicines through one of the pharmaceutical companies’ prescription assistance program.  AAFA-STL can help identify the best program for you, but it is the client’s responsibility to apply and get accepted.
  • Copay clients can renew annually and will be evaluated for continued eligibility.  High-deductible copay clients may be required to seek additional resources if they exceed this $925 limit.

All applications are reviewed individually and in a quick manner to provide immediate assistance. Parents and caregivers without access to the internet can call AAFA-STL directly at 314-645-2422 to obtain an application. All children/young adults enrolled in BREATH are evaluated periodically for continued eligibility.  AAFA-STL works with Beverly Hills Pharmacy, for our clients in Missouri and LV Healthy and Wellness Pharmacy both deliver medicines for free to our clients.

Asthma Medicine and Equipment Provided by BREATH:

  • List of Medicines Covered
  • Durable Medical Equipment:
    • Nebulizer Machines
    • Nebulizer accessories/attachments:
      • tubing kits with masks (medium or pediatric sizes available)
      • tubing kits without masks
      • masks only without tubing (medium or pediatric sizes available)
    • Peak Flow Meters
    • Spacers
      • with a mask (small or medium)
      • without a mask (generally for kids over the age of eight)
  • Allergic Bed Encasings – AAFA-STL will only provide two bed encasings and two pillowcases per child, per lifetime unless initial case is a crib.
  • Asthma Management/Educational Materials

Coverage Limits for BREATH:

  • Copay clients are covered until an annual financial limit of $925 is reached and can renew annually in May when AAFA-STL mails renewal paperwork.  High-deductible copay clients may be required to seek additional resources if they exceed this $925 limit.
  • Full-Pay Clients are covered for 3 months, until a financial limit of $925 is reached or until they are enrolled in health care coverage, whichever comes first.  It is AAFA-STL’s goal for full-pay clients to apply and get enrolled into MOHealthNet/Medicaid/IL All Kids.  It is mandatory that full-pay clients apply to their state Medicaid program.  Most clients will hear back on their Medicaid/MOHealthNet/IL All Kids applications within 3 months.  If you think you qualify for Medicaid/MOHealthNet/IL All Kids and were wrongfully denied coverage, call Advocates for Family Health at 314-534-1263.
  • Clients who receive only a bed encasing or durable medical equipment (i.e.,  Durable/Encasing Only Clients) and who do not enroll in BREATH’s prescription assistance program will only receive the durables/encasings from AAFA-STL and will not have ongoing coverage.  If Durable/Encasing-only clients need copay assistance, they should reapply to BREATH.

How To Apply:
Patients or a patient’s advocate can apply to BREATH by:

  1. Apply Online OR request a paper application by calling AAFA-STL at 314-645-2422 OR download the paper application.
  2. Collecting income verification for the entire household (generally the most recent tax return AND copies of the entire household’s latest pay stubs).  Click here to see examples of acceptable proof of income.
  3. Providing patient primary insurance information (for co-pay clients) – a copy of their insurance card (front and back) and their Rx card, if different.
  4. Mail/Fax all the application materials to:
    AAFA-STL
    1500 S. Big Bend, Suite 1 South
    St. Louis, MO 63117
    Fax: 314-645-2022

Income Verification:
Income Verification typically includes the previous year’s tax return and one month worth of most recent pay stubs for the entire household.
If the applicant filed income tax or was listed as a dependent on someone else’s income tax return for the most recently filed tax year, attach a copy of page one of the tax form. If no tax was filed or if the tax form does not represent current income, attach proof of income from all sources for the most recent 30-day period for the applicant and all members of the household. Please provide copies (not originals), of pay stubs, unemployment stubs, Social Security statements, pension statements, and any other sources of income.

About Beverly Hills Pharmacy (BHP) – for Missouri clients:

  • Accepts most insurance plans
  • Delivers for free
  • Works with AAFA-STL to provide medicines at the lowest price so we can help as many clients as possible

Beverly Hills Pharmacy – for Missouri clients
7150 Natural Bridge Road
St. Louis, MO 63121
Phone: 314-381-8600
Fax: 314-381-6844
Hours of Operation:  M-F, 8:30 a.m. – 5:30 p.m., Saturday: 9:00 a.m. – 1:00 p.m., Closed Sunday
http://www.bh-pharmacy.com/

LV Health & Wellness Pharmacy – for Illinois clients
1219 Thouvenot Ln Suite #111
Shiloh, IL 62269
Phone: 618-589-9889
Fax: 618-589-9880
Hours of Operation:  M-F, 9:00 a.m. – 7:00 p.m., Saturday: 9:00 a.m. – 2:00 p.m., Closed Sunday
https://www.lvhealthrx.com/

What to Expect Next:
After applying to BREATH, patients will receive a phone call from AAFA-STL to inform them of the status of their application and to answer any relevant questions.

If the client is not approved: AAFA-STL will provide additional asthma/allergy resources that the client may find useful.  We keep a list of up-to-date resources for full-pay and copay clients on our website that clients can access at any time.

If the client is approved, the client can expect/must:

  • Get their medicines filled at Beverly Hills Pharmacy (MO clients) or LV Health & Wellness Pharmacy (IL clients) who deliver medicines for free to our clients.
  • Get their asthma/allergy prescriptions over to the pharmacy by transferring them from a different pharmacy or by having their prescribing doctor call either call or fax prescription information to BHP (MO clients) or LV Pharmacy (IL Clients).
  • Call the pharmacy and tell them you are a client of AAFA-STL, you would like to fill your asthma/allergy prescriptions and would like to arrange delivery or pick up.
  • To receive their welcome packet which will be mailed within two weeks of the welcome phone call.
  • Complete mandatory surveys:
    • Complete mandatory periodic surveys about how their child’s asthma is doing.  A typical full-pay client will receive a survey with the welcome packet and again after their coverage through AAFA-STL ends. A typical co-pay client will receive a a survey with the welcome packet, again at two months & six months in their first year. After their first year, copay clients will receive a survey twice a year.   AAFA-STL reserves the right to stop coverage at any time at the discretion of the staff and/or board of directors.
  • Keep in touch with AAFA-STL:
    • Promptly notify AAFA-STL if any information in his/her application changes at any time, including any change in the patient’s income level, financial situation, insurance or medical condition.
  • Do their part:
    • Full-pay clients must apply for health coverage to ensure children have adequate coverage after the BREATH program ends.  Please let AAFA-STL know what Medicaid/MOHealthNet/IL All Kids determines for the client.
    • Copay clients are eligible to reapply annually in May for continued assistance.