Patient Assistance Programs
Charitable Programs

Patient Assistance Programs (PAPs)

Some pharmaceutical companies offer their products to low-income individuals for free or at reduced prices through patient assistance programs (PAPs) and drug discount programs which have also been referred to as "indigent patient programs" in the past. Many of these programs either no longer offer their services to Medicare beneficiaries who are eligible for or enrolled in a Medicare Part D plan, or require some attempts to have the Part D plan pay for a medication before they will assist.

Please note: PAPs are not comprehensive insurance plans and therefore are not considered "creditable coverage." Also, where PAPs do assist Part D beneficiaries who are in the coverage gap ("doughnut hole") the price of those drugs does not currently count towards True Out-Of-Pocket costs (TrOOP) and it extends the coverage gap for the calendar year. Drugs that are purchased at network pharmacies and on their Part D plan's formulary are the only prescriptions that count towards TrOOP.  Sources that do count towards TrOOP are all payments made by beneficiary, relatives, friends, or charitable foundation contributions (see below for a partial list) State Pharmaceutical Assistance Programs (SPAPs), and waivers or reductions by in-network pharmacists and formulary medications. Please see HAP's handout on "What Are True Out-of-Pocket (TrOOP) Costs Under Medicare Prescription Drug Coverage?"

The Centers for Medicare & Medicaid Services (CMS) has created a dedicated website that compiles detailed information about all of the PAPs available through every drug manufacturer. The site lists medications by name to find out whether the companies offer it free or at low cost. Please also keep in mind that most of these programs review applications on a case-by-case basis, regardless of their official eligibility criteria.  In each case, it will be up to beneficiaries and counselors to decide whether or not to contact any of these plans directly to obtain more definitive information. 

If you have any questions or need further assistance, please do not hesitate to email us at shiphelp@hapnetwork.org

Charitable Programs

These programs assist dual eligibles, and others in financial need who cannot afford their co-payments or co-insurances, coverage gap costs ("doughnut hole") and/or other health insurance related expenses such as premiums, on a case-by-case basis dependent upon diagnosis and prescription needs. These are all nationally based programs. In some areas, local faith-based groups or foundations can also defray some of these costs.

Other Resources for Low Cost Prescriptions

Sources: The information in the above charts was taken from the programs' websites.  Information was also obtained from interviews with program representatives.  Information is current as of 3/8/06.

Contact information for the Patient Assistance Programs of Pharmaceutical Companies is also available.