Everything You Need to Know about Patient Assistance Programs

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Everything You Need to Know about Patient Assistance Programs

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While employee health insurance programs help Americans bear their medical expenses, the gaps in coverage and restrictions mean they’re not fully covered for all the expensive medications. In addition to that, millions of Americans without health insurance have to self-fund their medication.

Patient Assistance Programs, or simply PAPs, are services provided by pharmaceutical companies to help patients who don’t have health insurance or are underinsured, and are looking for ways to pay for healthcare. With PAPs, patients get access to expensive medications at lower costs, or in some cases, none at all.

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PAPs Provided by Drug Manufacturers

Most pharmaceutical companies provide PAPs to eligible patients. Eligibility mostly depends on the financial needs of a patient.

Patients who have no health insurance, have insurance but no coverage for the specific medication, or spend a certain amount from their annual income are generally eligible for these services.

Check Your Eligibility

To help you find the right assistance program, Pharmaceutical Research and Manufacturers of America have developed a Medicine Assistance Tool (MAT). You only need to provide MAT with the name of the medication you need and some preliminary information. MAT will list the programs you’re eligible for.

PAPs Provided by Non-Profit Organizations

NGOs usually provide PAPs to patients who have some sort of health insurance. Some NGOs only cater to patients who’re enrolled with Medicaid, Medicare, or have military insurance.

To be eligible for PAPs from NGOs, the patient must generally be:

  • Already under treatment.
  • Subscribed to a health insurance plan.
  • The program covers the specific medications.
  • Is a US national.


Roadblocks to PAPs Enrollment

While PAPs provide medication to people who can’t afford it, it’s not that easy. Patients complain about the complex and tedious application process, especially those with chronic conditions, who mostly rely on multiple drugs.

Patients also face difficulty in documenting the income requirements for the application. The differences in applications of various PAPs create confusion amongst patients. In addition to that, the unexpected changes and the need to reapply also make the process unnecessarily complicated.

Things to Keep in Mind

Before you start searching for the right PAP for yourself, contact your doctor or pharmacist, as they’re more likely to be aware of a program that best suits your needs. Once you’re sure about the program, you must get your paperwork ready, which includes proof of your income, proof of your residence, and a front and back copy of your insurance card (where applicable). The information about the prescription will be provided by your healthcare provider.

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Advocate My Meds is a prescription assistance organization in the US that helps patients finance their medications. We offer full-service prescription assistance programs to patients without insurance, as well as to those who have partial insurance. For more information, get in touch with us today.