Project Concern for Individuals 

About Project Concern for Individuals
Project Concern is a comprehensive asthma and allergy management program that provides medications, equipment, education and support to to eligible children/young adults up to the age of 22 who have been diagnosed with asthma and/or allergies of all types and who are either uninsured or underinsured.  Uninsured means that you have no health care coverage.  Underinsured means your insurance covers medicines, but you cannot afford the copayments required.  For both types of children/young adults, AAFA-STL may be able pay the costs associated with the asthma and allergy medicines listed on our formulary. AAFA-STL provides full-pay and co-pay prescription assistance to those who qualify.

Eligibility
Project Concern serves children and young adults up to the age of 22 who either:

  1. have no insurance and are  in the process of applying for MO Medicaid, MO HealthNet for Kids or 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

All Project Concern clients:

  • are under the age of 22,
  • come from families that fall within 200% of the Federal Poverty Level guidelines, based on family size  AND
  • 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 Project Concern Work?
Project concerns serves Copay (with insurance) and Full-pay clients (no insurance) clients 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 company’s 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. Parent and caregivers without access to the internet can call AAFA-STL directly at 314-645-2422to obtain an application. All children/young adults enrolled in Project Concern are evaluated periodically for continued eligibility.  AAFA-STL works exclusively with Beverly Hills Pharmacy who delivers medicines for free to our clients.   Since Beverly Hills Pharmacy is not open 24 hours a day, we also enroll clients in Walgreen’s to fill medicines in emergencies only.

Resources covered by Project Concern for Individuals

  • Approved Allergy & Asthma Medications
  • Durable Medical Equipment
    • Nebulizers 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 one bed encasing and one pillow case per child, per lifetime unless initial case is a crib.
  • Asthma management/educational materials

Coverage Limits for Project Concern

  • Copay clients are covered until an annual financial limit of $925 is reached and can renew annually in May when AAFA-STL mails out out 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 as they might be able to help.
  • Clients who receive only a bedding encasing or only durable medical equipment (ie, a Durable/Encasing Only Clients) and who do not enroll in Project Concern’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 Project Concern.

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

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

About Beverly Hills Pharmacy (BHP)

  • 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
  • Contact Information:
    7150 Natural Bridge Road
    St. Louis, MO 63121
    Phone: 314-381-8600
    Fax: 314-381-6844
  • Hours of Operation (as of 06/2012):
  • M-F, 9:00a.m. – 5:30 p.m.
  • Saturday: 9:00a.m. – 1:00 p.m.