If a brand-name drug is straining your budget, a patient assistance program may cover it. Here is how these programs work and who is eligible.
What are patient assistance programs?
Patient assistance programs are charity-style programs, run by pharmaceutical manufacturers or independent nonprofits, that provide prescription drugs free or at low cost to people who cannot afford them. Manufacturer PAPs usually cover their own brand-name drugs and set income limits, often around 200-500% of the federal poverty level. Nonprofit foundations such as the PAN Foundation, HealthWell Foundation, and the Assistance Fund give grants tied to specific diseases. NeedyMeds and RxAssist maintain free directories of hundreds of these programs. Applications typically need proof of income, residency, and a prescription or signature from your doctor.
Can Medicare beneficiaries qualify?
Yes, though it depends on the program. Many manufacturer PAPs exclude people with Medicare Part D, steering them instead to foundation grants and Extra Help. Disease-specific nonprofit foundations, however, often welcome Medicare beneficiaries and can cover Part D copays for conditions like cancer, rheumatoid arthritis, and diabetes. Because rules vary by drug and program, it is worth checking each one. A 1-800-MEDIGAP agent can identify which programs accept Medicare for your specific medications so you do not waste time on applications you cannot use.