I used to have patient assistance with asacol, and i think it was required that you were uninsured to participate, not under-insured. That's how it was then anyway. under-insured is an equally terrible situation that is often not accounted for and should be. I also had to provide tax records to prove my income was below a certain amount to qualify - but that was then, not sure how things work now. I am sure all programs are different. That was through P&G i believe.
You could order from outside the country, or you could switch to another med with a better savings card
Apriso was always great with their card, but I always hated their capsules compared to Lialda. Lialda seemed so much easier to get a bigger dose in less pills.
What's your max out of pocket? if you're close, and you need a lot of medical, sometimes it makes sense to just get there so you can get whatever you need.