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How Patient Assistance Programs Work

Get Your Medication for FREE With Patient Assistance Programs

If the cost of a brand-name medication is putting it out of reach, a Patient Assistance Program (PAP) could help you access it for free. PAPs are benefit programs sponsored directly by pharmaceutical manufacturers for patients who would otherwise be unable to afford their medication, regardless of insurance status.

NowPatient’s Patient Assistance Program Search lets you check in seconds whether a PAP exists for your medication. A short eligibility quiz then determines whether you qualify. This search service is completely free.

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Your Guide to Using the Patient Assistance Programs App Feature

  • Step 1.

    Go to the tools page. Select Patient Assistance Programs. You can select the star icon on the tool and this will create a shortcut on your dashboard for ease of future use

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  • Step 2.

    Using the action button select ‘Search Medication’

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  • Step 3.

    Start your search by entering the name of your medication. If a Patient Assistance Program (PAP) exists, then you will see your medication appear in the drop-down box

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  • Step 4.

    After you have selected the medication, you will be asked to complete a short eligibility quiz

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  • Step 5.

    If you qualify, you will be sent a notification which will provide you with all the information and documents required to complete your submission to the pharmaceutical company that sponsors the program.  The notification will be available in your ‘My Notifications’ on your dashboard

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SERVICE GUIDE

How Patient Assistance Programs Work

What Is a Patient Assistance Program (PAP)?

Patient Assistance Programs are manufacturer-sponsored benefit programs that provide brand-name prescription medications free of charge to qualifying patients. They are designed to help people access clinically preferred medications that would otherwise be unaffordable.

PAPs enable physicians to prescribe the most appropriate brand-name medication for a patient’s condition, even where cost would normally be a barrier. Qualifying patients receive their medication either via a free pharmacy card or through direct shipment to their home or doctor’s office — depending on the program.

How Are PAPs Different from Drug Coupons?

This is an important distinction. The two programs work very differently:

  • Patient Assistance Programs (PAPs): Cover the full cost of the medication, regardless of your insurance status or plan coverage. The medication is provided free to qualifying patients. PAPs are available to uninsured, underinsured, commercially insured, and government-insured patients.
  • Drug coupons / copay cards: Only available to commercially insured patients. They reduce the copay or coinsurance portion of your medication cost, they do not cover the full cost, and they cannot be used if you are uninsured or have government insurance (Medicare, Medicaid, TRICARE, VA).

PAPs are significantly more comprehensive and accessible to a broader range of patients.

Who Can Qualify for a Patient Assistance Program?

Unlike drug coupons, PAPs are not limited to patients with commercial insurance. Eligibility requirements vary by pharmaceutical company and program, but as a general guide:

  • Uninsured or underinsured with no drug coverage: Almost all PAPs are designed specifically for patients in this situation. You are very likely to qualify.
  • Commercially or privately insured but unable to afford your copay or coinsurance: You may qualify. Eligibility requirements vary between manufacturers. Complete the NowPatient eligibility quiz to find out.
  • Covered by government insurance (Medicare, Medicaid, TRICARE, VA, etc.): You may qualify. Unlike drug coupons, PAPs are not automatically excluded for government-insured patients. Eligibility varies by program. Complete the NowPatient eligibility quiz to determine your qualification status.

Because each pharmaceutical company sets its own PAP terms, NowPatient’s eligibility quiz is the fastest and most reliable way to find out whether you qualify for your specific medication.

What Will I Pay for My Medication?

This depends on the program sponsor. If you qualify:

  • Some pharmaceutical companies will send you a card that allows you to obtain the medication at your local pharmacy for free.
  • Other pharmaceutical companies will ship the medication directly to your home or to your doctor’s office at no cost to you.

NowPatient will explain the specific method of supply for your medication after you complete the eligibility quiz.

How to Find and Apply for a PAP

Checking whether a PAP exists for your medication takes just a few minutes and is handled from within your NowPatient account:

  1. Open the Patient Assistance Programs Service Card. Go to the Drug Savings section of the account homepage and locate the Patient Assistance Programs service card.
  2. Search for your medication. Using the options button on the card, select ‘Search’. You will be taken to a search page where you can start entering the name of your brand-name medication into the search field. If a PAP exists, your medication will appear.
  3. Complete the eligibility quiz. After selecting your medication, you will be prompted to complete a short eligibility quiz. This checks whether you meet the pharmaceutical company’s terms and conditions for that specific PAP.
  4. Receive your notification. If you qualify, you will receive a notification in the Notifications Section of the account home page. This will include all the information and instructions to access documents that are required to be completed by both you and your doctor and submitted to the pharmaceutical company.
  5. Submit your application. Follow the instructions in your notification to complete and submit your application. You can manage this yourself or, if you prefer, you can use our affiliate partner, Prescription Bliss who provide a fully managed option for a small monthly fee for $50 per medication, per month.
  6. Using Prescription Bliss. If you wish to use Prescription Bliss, you can select the ‘Get Help Now’ button on the success screen after you have completed the eligibility. If you select this option, we will send the information to Prescription Bliss, who will arrange for one of their PAP advocates to reach out to you and start the application process.

Enrollment Options

Self-Enroll Free or Use Full-Service Management

Once you have confirmed eligibility, there are two ways to enroll in a Patient Assistance Program:

Option 1: Self-Enrollment (Free)

NowPatient provides everything you need to enroll in a PAP independently, at no cost:

  • Patient Assistance Program search tools
  • Eligibility quizzes
  • Application forms and enrollment materials
  • Educational resources about the process

The self-enrollment process typically involves the following steps:

  1. Searching for your medication’s PAP
  2. Completing the eligibility quiz
  3. Gathering required documentation (proof of income, insurance information, etc.)
  4. Obtaining prescription and physician forms
  5. Submitting applications to pharmaceutical manufacturers
  6. Following up on your application status
  7. Tracking re-enrollment deadlines (most programs require annual renewal)
  8. Managing refill orders
  9. Reapplying before your enrollment expires

Option 2: Full-Service Enrollment with Prescription Bliss ($50/month)

Navigating Patient Assistance Programs can be overwhelming. The application process involves extensive paperwork, coordinating with healthcare providers, gathering financial documentation, and managing ongoing renewals and refills throughout the year.

NowPatient has partnered with Prescription Bliss to handle everything on your behalf. For just $50 per calendar month, Prescription Bliss provides comprehensive, end-to-end PAP management.

What Prescription Bliss Handles for You

Initial enrollment:

  • Completes all PAP applications on your behalf
  • Gathers and submits all required documentation
  • Coordinates directly with your healthcare provider
  • Communicates with pharmaceutical manufacturers
  • Tracks your application status
  • Ensures you receive your medication

Ongoing management:

  • Handles all re-enrollment requirements (programs typically require annual renewal)
  • Manages all refill orders throughout the year
  • Monitors expiration dates and deadlines
  • Ensures continuous, uninterrupted medication access
  • Provides ongoing support and answers questions
  • Acts as your advocate with pharmaceutical companies

With Prescription Bliss, you simply:

  • Sign up through NowPatient
  • Provide your basic information and prescription details
  • Let Prescription Bliss handle everything else

No paperwork. No deadlines to track. No coordination headaches. Just continuous access to your medication.

What If I Don’t Qualify for a PAP?

If you have government insurance and do not qualify for a PAP, and are still struggling to afford your medication, consider the following options:

  • Low Income Subsidy (LIS) / Extra Help: Apply online at https://www.ssa.gov/medicare/part-d-extra-help or call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
  • State assistance programs: Such as Medicaid. Contact your state’s Medicaid office to check eligibility.

Additional Assistance Organisations

If you have already applied to Medicaid and received a denial letter, the following independent patient assistance organisations may be able to provide financial support with your medication costs:

Patient Access Network (PAN) Foundation

PAN may be able to assist if you meet one or more of the following criteria:

  • Income below 400% of the federal poverty level
  • Medication prescribed for an FDA-approved indication
  • You live in and receive treatment in the US or US territories (citizenship is not required)
  • Your medication is on PAN’s list of covered medications

Visit the Patient Access Network Foundation at https://www.panfoundation.org/ for more information.

HealthWell Foundation Copay Program

HealthWell may assist if you meet all of the following criteria:

  • You live in and are being treated in the United States
  • You are insured with a plan that covers your medication
  • Your medication is on the HealthWell Foundation’s list of covered medications

Visit the HealthWell Foundation at https://www.healthwellfoundation.org/ for more information.

Patient Advocate Foundation Co-Pay Relief Program

This program provides direct financial assistance for copays, coinsurance, and deductibles to reduce financial hardship. To qualify, you must meet all of the following:

  • Currently insured with coverage that includes your medication
  • Confirmed diagnosis and active treatment plan
  • You reside in and receive treatment in the United States
  • Income at or below 300% or 400% of the Federal Poverty Guideline (based on Cost of Living Index and household size)

Visit the Patient Advocate Foundation Co-Pay Relief program at https://copays.org/ for more information.