What Are Patient Assistance Programs?

While employer health insurance and government programs like Medicare offer prescription coverage for many Americans, there are still a large number of people who fall through the coverage gap. 

Patient assistance programs (PAPs) are offered by many pharmaceutical manufacturers. These programs provide eligible patients with access to brand-name medications at little or no cost.

There are a growing number of PAPs available in the U.S. While most of these programs are funded by drug companies, there is an increasing number offered by states, local governments, and non-profit organizations. Regardless of the organization offering them, PAPs can be a big help to anyone who is unable to afford their medication.

How Patient Assistance Programs Work

Patient assistance programs provide medications for free or at a reduced cost for individuals who are uninsured or underinsured and can’t afford their medication.

Each program differs, however, most will require patients to complete an application form. Some programs may also require financial and medical information from the applicant. In addition, almost every PAP will require some level of information from your doctor. Some programs only request your doctor’s signature while others may require your doctor complete a form. 

Once you have been accepted by the program, your medication may be delivered in several different ways. Some PAPs distribute the medication directly to your doctor’s office, some will send it to a pharmacy, and others may send the medication directly to you. 

Qualifying For Patient Assistance Programs

Eligibility requirements will vary for each patient assistance program. However, there are a number of common requirements that patients must meet to qualify for a program. 

• Health requirements – Organizations often require patients to provide proof of need for the drug. A written prescription for the medication is often enough, but some programs may require additional documentation, including signed forms from the patient’s doctor.
• Insurance Requirements – Patients will typically have to provide proof that they are uninsured, under insured, or that their insurance plan does not cover the medication or medical supply.
• Financial Requirements – Income is another qualifying factor considered by organizations offering PAPs. In order to qualify, patients must demonstrate a financial need. PAPs often use the Federal Poverty Guidelines to establish qualifying income thresholds and some will use tiered eligibility requirements; in other words, a patient in the lowest income tier may receive the medication completely free, while someone in the next eligibility tier will receive the medication at a discount.

Each PAP’s benefits will vary widely and they often have different requirements for patients. If you’re unsure of the program’s requirements, programs will often have a support line you can contact with questions. 

Patient Assistance Programs vs. Prescription Discount Cards

While looking for help to save on prescriptions, you might come across information about both PAPs and prescription discount cards. While both are meant to help individuals lower their prescription costs, they differ in how they work and who is eligible. 

You might also find information about manufacturer copay coupons. These programs can also provide significant savings to patients who qualify for them. You can read more about how they work in the blog post, “What Are Drug Coupons, Why Do They Exist and How Do They Work?”

Unlike PAPs and copay coupons, most prescription discount cards, including the ScriptSave WellRx discount card, are available to anyone, regardless of financial or insurance status. Additionally, you are not required to involve your doctor or meet any medical requirements to use your discount card.

While PAPs are usually sponsored directly by pharmaceutical companies, prescription discount card programs help people save by negotiating discounted cash prices on both generic and brand name medications. Patients can then receive lower cost prescriptions by showing their discount card at participating pharmacies.

Related Article: Rx Discount Cards vs Drug Coupons

Prescription Savings With ScriptSave WellRx

ScriptSave WellRx is freely available to anyone and is accepted at thousands of pharmacies across the U.S. If you’re searching for savings on your prescription medications, get your ScriptSave WellRx discount card and start saving today.