If the cost of medical treatment is a burden for you and your family, you should talk to your healthcare team about your concerns and see what options are available. Your doctor may be able to switch you to less expensive, but equally effective treatments. You should also ask about the types of patient financial assistance programs that are available to help you cover expenses.
Most financial assistance programs, but not all, have eligibility requirements based on need and whether or not you have health insurance that includes drug coverage. You will need to provide information about your age, your income, your insurance plan and either your illness or the prescription medicines you are taking.
If you don't have health insurance, the website Healthcare.gov has detailed information about how to get healthcare coverage you can afford. You can also get connected to organizations in your community that can help you enroll. These resources can help you learn more about shopping for health insurance and choosing a plan.
Some things to watch out for looking for financial assistance programs:
- Some private insurance plans are adopting a new kind of policy, called a copay accumulator program, that does not count the financial assistance received toward a patient's deductible or out-of-pocket maximum. This means patients may still face burdensome out-of-pocket costs to get the care they need.
- Drug company discount coupons cannot be used by people who are participating in a state or federally-funded healthcare program, including Medicare and Medicaid and Tricare.
- Beware of scams. There are websites, phone scammers and even people going door to door offering prescription assistance programs and discount cards and asking for money. None of the reputable programs listed here will ever ask you for money.
Prescription Assistance Programs
Many pharmaceutical companies, pharmacy chains and nonprofit organizations offer programs that provide access to free or low-cost medicines. Eligibility requirements vary, so you need to check carefully to find a plan that works for you.
FamilyWize has partnered with pharmacies nationwide to negotiate prescription discounts. Free downloadable prescription discount cards can be used by everyone, regardless of financial need or insurance status. Their Drug Price Look Up Tool allows comparison shopping to find the lowest price.
The Medicine Assistance Tool (MAT) is a free-to-use search engine that focuses its searches on patient assistance resources available to eligible patients. The Pharmaceutical Research and Manufacturers of America (PhRMA) launched the MAT in 2019 to allow users to search for financial assistance resources available from PhRMA's member companies. MAT replaces PhRMA's Partnership for Prescription Assistance program (PPA).
NeedyMeds is a national non-profit organization that maintains a website of free information on a wide range of prescription assistance programs. Their resources include a telephone help line, a library of patient education information and a drug discount card that is available to everyone.
- RxAssist Patient Assistance Program Center
RxAssist is a web-based medication assistance resource center that offers a comprehensive directory of the patient assistance programs run by pharmaceutical companies, as well as tools and information to help patients manage their medication costs.
Charitable Patient Assistance Programs
Some charitable foundations and other nonprofits offer financial assistance that can be used to pay for a range of out-of-pocket costs associated with an illness. Depending on the program, patients who qualify may be able to use the funds for medicine, doctor visits, travel expenses and health insurance premiums.
The Patient Access Network Foundation's FundFinder is a web-based app designed to quickly notify registered users when financial assistance for their condition becomes available from any of the charitable patient assistance foundations.
In addition to Medicare and Medicaid, which provide benefits to all eligible Americans according to their age and income level, you may also be able to find assistance programs run by your state or local government.
BenefitsCheckUp is a free service of the National Council on Aging that allows seniors to search a database of over 2,500 benefits programs nationwide, including medication, housing, food and nutrition and income assistance.
Medicaid is a health coverage program for low-income people that is run by states, with some funding support from the federal government. Eligibility requirements and benefits vary state-to-state. For information about the Medicaid program in your area, contact your state Health Department.
This federal government website walks you through how to sign up for Medicare if you are 65 or older, as well as how to choose the Part D prescription drug plan that's best for you based on where you live, your income and what drugs you take. If you are on Medicare and have a very limited income, you may be eligible for Extra Help to pay for the costs—monthly premiums, annual deductibles, and prescription co-payments—related to a Medicare prescription drug plan.
Additional Assistance Programs
Beyond finding help to pay for medications and other treatments, these resources offer assistance in locating information or support.
211 is the most comprehensive source of local social services in the U. S. and Canada. For help with housing, utilities, food, addiction treatment and other services, call 211 or visit the website.
The American Lung Association's Lung HelpLine can answer questions you have about tobacco cessation, lung disease treatment plans, diagnostic tests and ways to keep your lungs healthy.
Page last updated: June 22, 2020