Frequently Asked Questions About Patient Assistance Programs

1. What are patient assistance programs?

2. How do Patient Assistance Programs work?

3. Do I have to be a U.S. citizen to be eligible?

4. What are the eligibility requirements for patient assistance programs?

5. What if I have no income for the last several months or years?

6. What do I have to do to apply?

7. What does my doctor need to do?

8. Do I need to pay anything to participate?

9. How long does it take for my medicine to arrive?

10. What do I do if I need a medication refill?

11. What happens if my doctor prescribes a new medication?

12. I have health insurance, but no prescription insurance; am I eligible for these programs?

13. I have health insurance and have reached my limit; am I eligible for patient assistance programs?

14. I have Medicare Part D. Do I qualify for these programs?

15. What do I do if the company decides that I do not qualify for its patient assistance program?

16. Are there programs for generic medications?

17. Why is my medication(s) not on a patient assistance program and, what should I do?

1) What are patient assistance programs?
A Patient Assistance Program (PAP) is set up by drug companies that offer free or low cost drugs to individuals who are unable to pay for their medication. Most of the best known and commonly prescribed drugs can be found in these programs. All of the major drug companies have patient assistance programs, although every company has different eligibility and application requirements.

Companies offer these programs voluntarily; the government does not require them to provide free medicine. There are over 4000 medications available to choose from offered free and discounted.

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2) How do Patient Assistance Programs work?
First, you can fill out our eligibility form to see if you qualify for free and/or discounted prescription medications. If you qualify you can then select medications from a list based on your eligibility information that are are available under a Patient Assistance Program. Click Here to check eligibility and medication.

After selecting your medications, our database will show you a medication report listing each medication. This report will show if you are eligible by stating whether there is a Free brand name program or a Discount Generic program available. We show the most recent pricing for Generic medications, however you do not pay us. You are offered the information and forms you need to order them direct via mail order.

Once you elect to participate you pay our service then. Then you will answer specific questions about your income and insurance and your application will be prefilled with these answers. You will be able to download/save your applications and print them from your personal printer.

You and the physician must sign the application form(s) and send them to each company. Most companies require that you send proof of income and a 90 day prescription with three refills with the application form. Specific instructions are included. The company may send the medication(s) to the patient's home, the physician's office or send a card to use at a local pharmacy depending on the program. Some, but not all, companies send letters informing patients and/or physicians whether the patient has been approved for their patient assistance program.

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3) Do I have to be a U.S. citizen to be eligible?
Anyone in the United States can participate in the discount generic medication programs. Only U.S. citizens can apply for Free medications. You will be asked for a social security number on your application for each medication.

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4) What are the eligibility requirements for patient assistance programs?
Eligibility varies program by program. Generally, for FREE Brand name medications, patient's must have a household total income under 200% of the 2010 Federal Poverty Level (that's an income below $29,140 for a family of two people), the patient cannot have prescription coverage from any public or private source and must be a U.S. citizen. For Generic discounted medications the eligibility requirements are up to 325% income. However, there are many Free Brand name Patient Assistance programs that have income limits higher than 200%, so it is best to check your eligibility using our free medication database. Click Here to check your eligibility.

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5) What if I have no income for the last several months or years?
If you have not applied for Medicaid in your state you should do so as soon as possible. Those that have applied and been denied should send the denial letter with your application you receive from us to obtain your medications. Many have lost their jobs and the change in income should be stated in a letter. Also you should attach a copy of a Declaration of Income. Here is a form letter you can use:

Click Here for Declaration of Income
(You will need a doctor or social worker to sign this form.)

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6) What do I have to do to apply?
First you must determine if you are eligible and then check to see if your medications are available on a program. Click Here to check eligibility and medication availability.

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7) What does my doctor need to do?
This depends on the patient assistance program. Your doctor will need to sign any applications to authorize the medications to be shipped to the doctor's office or direct to you. A prescription must be written on the application or attached depending on the program requirements. Usually the physician only has to fill out a few brief questions on the application form and sign it.

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8) Do I need to pay anything to participate?
There is an annual administrative and a monthly service fee per patient (not per drug) for you to use our research website and obtain your applications and instructions to necesssary to apply. Most patient assistance programs that supply Brand name medications do not charge for the medications. There are a few companies offering Generic medications that require a co-pay for a 90 day supply.

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9) How long does it take for my medicine to arrive?
It can take anywhere from 2 to 6 weeks for medication to arrive after the company approves your application to participate in their program.

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10) What do I do if I need a medication refill?
We will notify you by email several weeks in advance of when your medicine is due to be refilled. Refill processing depends on the program requirements. Some companies require a new application for each refill, others allow the doctor's office or patient to call in the request for a refill. Every company has a specific refill policy and our service assists you with all the information you need to keep your medications current. You can come back to the member portal and log in using your email and password to access your order information.

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11) What happens if my doctor prescribes a new medication?
If you need to start the medication right away have the doctor write one prescription for 30 days and get that filled. Ask for generic if possible. Once you have enrolled in our program you will be able to come back to the website anytime, login to the member portal and research any new medications. A medication report will instantly tell you if your medication is on a program and if you are eligible. You can then download and print your application form for your new medication program.

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12) I have health insurance, but no prescription insurance; am I eligible for patient assistance programs?
In most programs, the answer is yes. The main factor for eligibility is having no prescription coverage.

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13) I have health insurance and have reached my limit; am I eligible for patient assistance programs?
Technically, if you have reached your coverage limit you no longer have prescription coverage, but we suggest attaching a letter with your application that indicates this. If you have a letter from your insurer stating that you have used up your benefits, send that with your applications for each medication.

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14) I have Medicare Part D. Do I qualify for these programs?
No at this time those 65 and older and/or eligible for or enrolled in Medicare part D do not qualify for these Patient Assistance Programs.

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15) What do I do if the company decides that I do not qualify for its patient assistance program?
It is up to each company to decide who can have medication for free and who cannot. If you meet all the eligibility requirements for the program through our initial research you should be accepted.

For a variety of reasons, some patients are turned down for these programs. In that case, the best thing to do is ask your physician or health care advocate to make an appeal directly to the manager of the patient assistance program that explains exactly why you cannot afford to buy your medication. We suggest a letter followed by a phone call.

Click here for an example of an appeal letter to a patient assistance program - (5.15 kb Rich Text Format)

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16) Are there Patient Assistance Programs for generic medications?
Yes. We will inform you which generics are available on your report. These programs differ from other patient assistance programs in that they are not offered by the pharmaceutical manufacturer of the drug. These programs purchase generics in bulk then make them available via mail order to low income individuals. Both companies both charge a fee to receive the medications.

One company offers more than 400 different medications available in a 90 day supply at a cost from $20 to $45, depending on the medication. They will also offer 180 day supplies for some medications. In order to be eligible, your household income must be below 300% of the Federal Poverty Level

Another company offers over 250 medications and has different pricing levels, depending on the medication and quantity: $20 to $30 for a 90 day supply, $40 to $60 for a 180 day supply and $80 to $120 for a 360 day supply. A $3.85 shipping and handling fee is added for each order. Your household income limit for this program must be under 325% of the Federal Poverty Level.

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17) Why is my medication(s) not on a Patient Assistance Program and, what should I do?
There are over 4000 medications that are available through Patient Assistance programs.

1) Your medication may not be available on a patient assistance program by the pharmaceutical companies. These companies manufacture thousands of medications; however, they do not offer all of them on a program. You can use our feedback form to send us the name of your medication to confirm if it is available or not. We will let you know what the status is of any medication if the medication becomes available. Please only use this Feedback form if you want us to contact you in the future about a medication that we have told you is not available. You must have filled out an eligibility form requesting research and received a report from us before using the Feedback form.

2) Your doctor may want you to take only this particular medication; however, there are alternative medications that may be on patient assistance programs. You can ask your doctor if there is an approved alternative medication. Then you can come back to our website and research the alternative generic and brand name. We will make every effort to advise you of any alternatives we are aware of, but you will have to contact your doctor to get permission to change before we will supply an application for alternative meds.

3) You can ask your doctor if he has samples of your medication to help you better afford future purchases. By using our services for all or most of your medications, obtaining either an alternative for those not available or samples from the doctor, you will be on your way to affording your medications that you need to be taking regularly.

RX MEDS PARTNER is dedicated to offering the latest information available for your medication needs. We update our list of medications weekly based on reports from each company including new medications added, medications removed and new application forms available.