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What to know about patient assistance programs

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About these programsHow can they help me?How to find themHow to applyOptum Perks Discount CardSummary
Patient assistance programs can help improve access to healthcare. These programs can provide financial support and resources to help people afford prescription medications.
Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI
Written by Rashida Ruwa, RN
Updated on November 29, 2023

Managing healthcare costs can be a challenging task, especially when it comes to affording essential medications. Yet various financial assistance programs are available to help relieve the financial burden and ensure that people can access healthcare treatments. 

Certain pharmaceutical companies and nonprofit organizations offer patient assistance programs to help people who cannot afford prescription medications and find it challenging to cover the costs. 

What are patient assistance programs?

Adult male looking holding and looking at some papers at a home office and speaking on the phone possibly about patient assistance programs
Photography by Damircudic/Getty Images

A patient assistance program is a supportive initiative that provides financial or other assistance to help people who:

  • do not have health insurance
  • do not qualify for government-funded healthcare programs
  • cannot afford the high cost of prescription medications

Pharmaceutical companies, nonprofits, and government agencies typically manage these programs. They can offer various types of help, such as covering the total cost of medications or providing discounts.

Some programs also assist with insurance claims or help connect people with resources and support regarding their medical condition.

Yet the eligibility criteria for assistance programs may vary depending on the program and the medication. That’s why it’s important to research and compare different programs to determine which ones are appropriate for use in your situation.

How can they help me afford prescription medications?

Pharmaceutical companies, state programs, or nonprofit organizations often sponsor patient assistance programs.

These programs may offer help with obtaining your prescription medications, such as through direct delivery, copay assistance, or discounted prices. 

An assistance program can also help you afford prescription medication by providing access to free or low cost medications. Depending on the program, you may receive medications for free or at a lower discounted price.

These programs can also provide support if you do not have health insurance (uninsured) or have limited coverage (underinsured). They aim to help people who find it difficult to afford their medications due to their insurance status.

Additionally, when you experience gaps in your insurance coverage due to job changes, loss of benefits, or enrollment waiting periods, an assistance program can offer temporary support by ensuring uninterrupted access to essential medications. 

How to find patient assistance programs

To find a patient assistance program that may help you afford your prescription medications, follow these steps:

Research online databases

Begin your search by exploring online resources that compile information on assistance programs. These platforms allow you to search for programs specific to your medications and personal circumstances. This can help you narrow down options that may suit you more easily.

Check pharmaceutical company websites

Pharmaceutical companies often have assistance programs for their medications. Visit the websites of the companies that produce your prescribed medication, and look for sections dedicated to patient assistance or financial support programs. These sections typically provide information on eligibility criteria and application instructions.

Seek guidance from a healthcare professional

Consider talking with a healthcare professional for advice. They are often familiar with available assistance programs and can provide recommendations based on your specific needs. They may also have access to resources and contacts in the medical community that can help you find appropriate programs.

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Contact nonprofit organizations

Nonprofit organizations, including foundations or advocacy groups, may offer assistance programs or resources aimed at helping people with certain medical conditions. Consider contacting these organizations, as they often have information on financial aid options and can guide you in finding assistance programs that address your specific health needs.

Connect with local social services

Do not hesitate to contact local social services or the health department in your area. These agencies can provide information on available programs and referrals to local health centers within your community that can help cover medication costs. They may also have additional knowledge of local initiatives and support services.

How to apply for assistance

Applying for a patient assistance program involves several steps:

  1. Collecting documents: Before beginning the application, gather any required documents. This may include proof of income, identification, residency, and a healthcare professional’s prescription or recommendation. Having these documents ready will help simplify the application process.
  2. Completing the application form: Assistance programs typically require filling out an application form. This form asks you to include essential information about your financial situation, insurance coverage, and medical condition. Take your time filling it out, carefully providing accurate and complete details.
  3. Providing supporting documents: You may need to submit supporting documentation along with the application form. These documents can include proof of income, tax returns, or bank statements to verify your financial need. Some programs may require documentation from a healthcare professional to confirm your medical condition and the need for your prescribed medications.
  4. Submitting your application: Once you have filled out the application form and collected all necessary supporting documentation, submit your application according to the instructions provided. Programs may offer various submission methods, including submitting the application online, faxing it, or mailing it. Follow the specific instructions to ensure your application is received and processed accurately.
  5. Following up and staying informed: After submitting your application, it is important to stay informed about the progress and status of your application. You may receive notifications or requests for additional information from the program. Responding promptly and providing any requested documentation is crucial to preventing delays in processing your application.

Remember, each assistance program may have unique application processes and eligibility requirements. It is important to carefully review the guidelines provided by the specific program you are applying for to ensure you meet all prerequisites and submit the application correctly.

How can Optum Perks help?

If you are not eligible to use patient assistance programs but could still benefit from support when paying for your prescription medications, consider using a discount card. Prescription discount cards can help lower the cost of your medication and can be used with brand-name or generic drugs.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Summary

Patient assistance programs can help improve access to healthcare by providing financial support to people who may find it difficult to afford prescription medications.

They can offer several types of help, such as covering the total cost of medications or providing discounts.

You can find programs you are eligible for by researching online databases, checking pharmaceutical company websites, and reaching out to nonprofit organizations.

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