Prescription Drug Patient Assistance Programs

Description: Pharmaceutical companies or pharmacies that make brand name or generic prescription drugs available to patients who are uninsured or underinsured or, for other reasons, cannot afford to pay the market price. Also included are organizations that help qualifying patients complete and file paperwork for submission to drug manufacturers to request such medication or which maintain lists of these types of programs for referral purposes. (AIRS LH-6700.6300)

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Disclaimer...
Note: Service listings do not represent a recommendation or endorsement by the Medical Home Portal staff or its sponsoring organizations; nor do they reflect any assessment of the quality or value of a listed Service.

NV

Carson City, NV

3416 Goni Road
Carson City, NV 89706
Phone: 866-303-6323
Organization Name: Nevada Aging and Disability Services Division
Address: 3416 Goni Road
Carson City, NV 89706
Phone: 866-303-6323
Fax: 775-687-0576
Email: nvrx@adsd.nv.gov
Eligibility: Individuals 18 to 61 with a disability or 62 and older; has lived in Nevada the last 12 months prior to application; income guidelines; Medicare eligible.
Services Provided: 100% assistance with prescription costs when in the Medicare Part D coverage gap. Assists with a portion of monthly premiums with participating Medicare Part D plan through December 31st 2018.
Original Source: Nevada 2-1-1
Last Updated: 12/15/2017
3416 Goni Road
Suite D132
Carson City, NV 89706
Phone: 775-687-4210
Organization Name: Nevada Aging and Disability Services Division
Address: 3416 Goni Road
Suite D132
Carson City, NV 89706
Phone: 775-687-4210
Fax: 775-687-0576
Email: nvrx@adsd.nv.gov
Eligibility: Individuals 18 to 61 with a disability or 62 and older; has lived in Nevada the last 12 months prior to application; income guidelines; Medicare eligible.
Wheelchair Accessible: Yes
Services Provided: 100% assistance with prescription costs when in the Medicare Part D coverage gap. Assists with a portion of monthly premiums with participating Medicare Part D plan.
Original Source: Nevada 2-1-1
Last Updated: 3/18/2019
Address: Carson City, NV 89706
Eligibility: Nevada residents
Services Provided: Nevada Drug Card Program is a free statewide prescription assistance program to help uninsured and under-insured residents of Nevada afford their prescriptions.
Original Source: Nevada 2-1-1
Last Updated: 5/14/2019
2621 Northgate Lane
Suite 62
Carson City, NV 89706
Phone: 775-884-2269
Address: 2621 Northgate Lane
Suite 62
Carson City, NV 89706
Phone: 775-884-2269
Fax: 775-884-2730
Email: info@carson-family.org
Eligibility: Low income clients in coverage area.
Wheelchair Accessible: Yes
Services Provided: Provides resources to assist families with prescription needs.
Original Source: Nevada 2-1-1
Last Updated: 3/19/2019

Elko, NV

Organization Name: Elko Friends in Service Helping
Address: 821 Water Street
Elko, NV 89801
Phone: 775-738-3038
Fax: 775-777-1175
Wheelchair Accessible: Yes
Services Provided: Variety of services including showers/hygiene supplies, laundry facility/supplies, prescription/medical assistance, emergency clothing/furniture vouchers, aid for chronically homeless.
Original Source: Nevada 2-1-1
Last Updated: 8/2/2018

Fallon, NV

485 West B Street
Fallon, NV 89406
Phone: 775-423-6695
Address: 485 West B Street
Fallon, NV 89406
Phone: 775-423-6695
Fax: 775-423-8057
Email: socialservices@churchillcounty.org
Eligibility: Anyone in Churchill County may apply. Eligibility is determined by casework.
Wheelchair Accessible: Yes
Services Provided: Indigent medical and prescription assistance for those found to be indigent. Client must have applied for healthcare per Federal law and have no insurance coverage.
Original Source: Nevada 2-1-1
Last Updated: 3/19/2019

Las Vegas, NV

1860 East Sahara Avenue
Las Vegas, NV 89104
Phone: 775-687-4210
Organization Name: Nevada Aging and Disability Services Division
Address: 1860 East Sahara Avenue
Las Vegas, NV 89104
Phone: 775-687-4210
Fax: 775-687-0576
Email: nvrx@adsd.nv.gov
Eligibility: Individuals 18 to 61 with a disability or 62 and older; has lived in Nevada the last 12 months prior to application; income guidelines; Medicare eligible.
Wheelchair Accessible: Yes
Services Provided: 100% assistance with prescription costs when in the Medicare Part D coverage gap. Assists with a portion of monthly premiums with participating Medicare Part D plan.
Original Source: Nevada 2-1-1
Last Updated: 3/18/2019
1830 East Sahara Avenue
Las Vegas, NV 89104
Phone: 702-382-2326
Organization Name: Aid for AIDS of Nevada
Address: 1830 East Sahara Avenue
Las Vegas, NV 89104
Phone: 702-382-2326
Fax: 702-366-1609
Email: antioco@afanlv.org
Eligibility: HIV positive and below 400% of the FPL.
Wheelchair Accessible: Yes
Services Provided: Ryan White Part B: AIDS Drug Assistance Program offers assistance for HIV medication, medication co-pay, and medical insurance.
Original Source: Nevada 2-1-1
Last Updated: 6/6/2019
Organization Name: Community Outreach Medical Center
Address: 1140 Almond Tree Lane
Suite 306
Las Vegas, NV 89104
Phone: 702-657-3873
Fax: 702-636-0787
Email: efraire@nvcomc.org
Eligibility: Individuals with HIV/AIDS, Ryan White A eligible.
Wheelchair Accessible: Yes
Services Provided: Program provides eligibly for Ryan White Part A program, case management, adherence counseling, education/outreach events, transportation, food vouchers, nutritionist consultations, HIV/AIDS support group, and HIV/AIDS educational conferences.
Original Source: Nevada 2-1-1
Last Updated: 6/6/2019
431 West Plumb Lane
Las Vegas, NV 89106
Phone: 775-850-1440
Address: 431 West Plumb Lane
Las Vegas, NV 89106
Phone: 775-850-1440
Fax: 775-850-1444
Email: pharmacy@pharmacy.nv.gov
Eligibility: Cancer patients in need of cancer medication.
Services Provided: Offers a cancer drug donation program which allows participating pharmacies to accept cancer medications that were originally dispensed by Nevada Pharmacy. The drugs may be re-dispensed to Nevada resident currently being treated for cancer.
Original Source: Nevada 2-1-1
Last Updated: 1/19/2018

Pahrump, NV

Organization Name: Nye County Health and Human Services
Address: 1981 East Calvada Boulevard North
Unit 120
Pahrump, NV 89048
Phone: 775-751-7090
Fax: 775-751-4284
Eligibility: Persons with HIV/AIDS.
Wheelchair Accessible: Yes
Services Provided: Under Ryan White Part A (HIV/AIDS) provides case management, transportation assistance and vouchers, emergency rent and utilities, household cleaning and hygiene, and food pantry and vouchers for fresh/frozen/vegetables/meats.
Original Source: Nevada 2-1-1
Last Updated: 3/19/2019
1981 East Calvada Boulevard North
Unit 120
Pahrump, NV 89048
Phone: 775-751-7095
Organization Name: Nye County Health and Human Services
Address: 1981 East Calvada Boulevard North
Unit 120
Pahrump, NV 89048
Phone: 775-751-7095
Fax: 775-751-4284
Wheelchair Accessible: Yes
Services Provided: Provides prescription expense assistance to those who qualify when funding is available.
Original Source: Nevada 2-1-1
Last Updated: 9/6/2018

Reno, NV

985 Damonte Ranch Parkway
Reno, NV 89521
Phone: 775-850-1440
Address: 985 Damonte Ranch Parkway
Reno, NV 89521
Phone: 775-850-1440
Fax: 775-850-1444
Email: pharmacy@pharmacy.nv.gov
Eligibility: Cancer patients in need of cancer medication.
Wheelchair Accessible: Yes
Services Provided: Offers a cancer drug donation program which allows participating pharmacies to accept cancer medications that were originally dispensed by Nevada Pharmacy. The drugs may be re-dispensed to Nevada resident currently being treated for cancer.
Original Source: Nevada 2-1-1
Last Updated: 6/6/2019
7910 North Virginia Street
Reno, NV 89506
Phone: 775-829-2273
Organization Name: CARE Chest of Sierra Nevada
Address: 7910 North Virginia Street
Reno, NV 89506
Phone: 775-829-2273
Fax: 775-829-8745
Email: info@carechest.com
Eligibility: Must meet income guidelines and live in the state of Nevada
Wheelchair Accessible: Yes
Services Provided: Offers up to $100 annually to supplement the costs of emergency prescriptions or co-pays to qualified individuals in need. Pain medications are not covered.
Original Source: Nevada 2-1-1
Last Updated: 6/26/2018
639 Isbell Road
Suite 460
Reno, NV 89509
Phone: 775-322-8668
Address: 639 Isbell Road
Suite 460
Reno, NV 89509
Phone: 775-322-8668
Fax: 775-322-2798
Email: Kelsey.piechocki@uwnns.org
Wheelchair Accessible: Yes
Services Provided: Provides familywize prescription discount cards that can reduce the cost on average by 45%. Covers all FDA approved prescriptions medications.
Original Source: Nevada 2-1-1
Last Updated: 3/20/2019

Tonopah, NV

Organization Name: Nye County Health and Human Services
Address: 101 Radar Road
Tonopah, NV 89049
Phone: 775-482-8125
Fax: 775-482-7261
Eligibility: Persons with HIV/AIDS.
Wheelchair Accessible: Yes
Services Provided: Under Ryan White Part A (HIV/AIDS) provides case management, transportation assistance and vouchers, emergency rent and utilities, food pantry, household cleaning and hygiene vouchers, and fresh/frozen vegetables/fruits/meats vouchers.
Original Source: Nevada 2-1-1
Last Updated: 3/19/2019
101 Radar Road
Tonopah, NV 89049
Phone: 775-482-8125
Organization Name: Nye County Health and Human Services
Address: 101 Radar Road
Tonopah, NV 89049
Phone: 775-482-8125
Fax: 775-482-7261
Wheelchair Accessible: Yes
Services Provided: Provides prescription expense assistance to those who qualify when funding is available.
Original Source: Nevada 2-1-1
Last Updated: 9/6/2018

Nationwide

PO Box 29038
Phoenix, AZ 85038-9038
Address: PO Box 29038
Phoenix, AZ 85038-9038
Toll Free Phone: 866-728-4368
Eligibility: Patients must live in one of the 50 states or the District of Columbia; have no prescription drug benefits through any insurer/payer/program; have gross monthly household income at or below certain levels.
Services Provided: Bridges to Access is GlaxoSmithKline's patient assistance program that provides GSK non-oncology medicines—at no cost—to qualified patients.
Original Source: MedHome Portal
Last Updated: 1/10/2019
Irving, TX 75063
Phone: 877-321-2652
Address: Irving, TX 75063
Phone: 877-321-2652
Toll Free Phone: 877-321-2651
Eligibility: Call or visit website for information on participating counties.
Services Provided: Provides up to 24% off the pharmacy's regular price on all commonly prescribed prescriptions. Savings are also available on specialty medications (high-tech and injectable drugs), mail order as well as pet medications.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
1720 Spillman Drive Ste 100
Bethlehem, PA 18015
Phone: 866-810-3784
Organization Name: FamilyWize Community Service Partnership
Address: 1720 Spillman Drive Ste 100
Bethlehem, PA 18015
Phone: 866-810-3784
Email: info@familywize.org
Eligibility: No restirctions
Services Provided: Provides a prescription drug discount card at no cost. The FamilyWize card can also be used for pet medications.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
Address: 6900 N. Dallas Parkway, Suite 200
Plano, TX 75024
Phone: 877-968-7233
Fax: 214-570-3621
Email: info@cdfund.org
Eligibility: Patients suffering from chronic medical conditions who have limited financial means.
Services Provided: Helps patients get access to the medications they need, pay insurance co-pays, transportation, insurance premiums, finding insurance coverage, and emotional support.
Provider Profiles: Hours: 8:00 a.m. to 5:00 p.m. CST
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
Address:
Services Provided: A website to search for lowest price prescription drugs based on location. Offers coupons, will send refill reminders and alerts when prices change.
Original Source: MedHome Portal
Last Updated: 4/25/2018
PO Box 220410
Chantilly, VA 20153-0410
Phone: 800-675-8416
Address: PO Box 220410
Chantilly, VA 20153-0410
Phone: 800-675-8416
Fax: 800-282-7692
Email: Grants@HealthWellFoundation.org
Eligibility: Patients living with chronic and life-altering illnesses. Must meet income and diagnosis requirements. Call for specific information.
Services Provided: Provides financial assistance to eligible individuals to cover coinsurance, copayments, health care premiums and deductibles for certain medications and therapies.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 6/17/2019
Address: 6645 West North Avenue
Oak Park, IL 60302
Phone: 708-383-0808
Toll Free Phone: 800-362-4423
Eligibility: Children with endocrine disorders.
Services Provided: The Magic Foundation provides information, resources, and an insurance and appeals assistance program, designed to assist members in the insurance appeals process as funding allows. Programs include: Pharmaceutical Company Patient Assistance Programs, Co-Pay Assistance Foundation, Insurance Appeals.
Provider Profiles: An organization of parents of children with endocrine disorders.
Original Source: MedHome Portal
Last Updated: 8/1/2018
Address:
Eligibility: Low income and relatively few assets, reside in one of the 50 States or the District of Columbia.
Services Provided: Although pharmacy coverage is an optional benefit under federal Medicaid law, all states currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and most other enrollees within their state Medicaid programs.
Original Source: MedHome Portal
Last Updated: 8/1/2018
PO Box 515
Doniphan, MO 63935-0515
Phone: 573-996-7300
Address: PO Box 515
Doniphan, MO 63935-0515
Phone: 573-996-7300
Toll Free Phone: 888-812-5152
Email: help@themedicineprogram.com
Eligibility: No prescription insurance coverage, applicant does not qualify for a government program, patient's income at a level to cause hardship if purchasing retail.
Services Provided: Our function, in cooperation with the physician, is to assist patients who may qualify to enroll in one or more of the many patient assistance programs now available. These programs provide prescription medicine free-of-charge to individuals in need, regardless of age, if they meet the sponsor's criteria.
Provider Profiles: $5 fee for processing each medication requested
Original Source: MedHome Portal
Last Updated: 5/31/2018
Address: 55 Kenosia Avenue
Danbury, CT 06810
Phone: 203-744-0100
Toll Free Phone: 800-634-7207
Fax: 203-263-9938
Eligibility: Persons with a rare disease.
Services Provided: NORD is a unique federation of voluntary health organizations dedicated to helping people with rare "orphan" diseases and assisting the organizations that serve them. NORD is committed to the identification, treatment, and cure of rare disorders through programs of education, advocacy, research, and service. Co-pay Assistance Program.
Patient Assistance Program, RareCare: helps patients obtain life-saving or life-sustaining medication they could not otherwise afford. These programs provide medication, financial assistance with insurance premiums and co-pays, diagnostic testing assistance, and travel assistance for clinical trials or consultation with disease specialists.
Original Source: MedHome Portal
Last Updated: 6/3/2019
PO Box 382377
Birmingham, AL 35238
Phone: 800-334-8134
Organization Name: Prescription Benefits, Inc.
Address: PO Box 382377
Birmingham, AL 35238
Phone: 800-334-8134
Fax: 205-980-2354
Email: generalinfo@rxbenefits.com
Services Provided: Nationwide provider of discount pharmacy cards for individuals, families, and seniors.
Original Source: MedHome Portal
Last Updated: 2/20/2018
50 Whittemore Street
Gloucester, MA 01930
Phone: 800-503-6897
Organization Name: NeedyMeds
Address: 50 Whittemore Street
Gloucester, MA 01930
Phone: 800-503-6897
Fax: 206-260-8850
Email: info@needymeds.org
Eligibility: There are no income, insurance, age, or residency requirements.
Services Provided: Provides a free drug discount card that offers a discount of up to 80% off prescriptions drugs, medical supplies written on a prescription form, over the counter drugs, and pet prescriptions.

Offers applications and information so that people can apply directly to drug manufacturers and other organizations that provide assistance. The application process is strictly between the applicant and the manufacturer.
All of the information on the website is at no cost and is updated daily.
Provider Profiles: 90 day w refills. Turnaround 3-4 weeks; physician sends in prescription
Original Source: Nationwide Suggest Providers Queue
Last Updated: 6/3/2019
Washington, DC 20004
Phone: 888-477-2669
Address: Washington, DC 20004
Phone: 888-477-2669
Eligibility: Qualifying patients without prescription insurance
Services Provided: Online access to more than 475 public and private programs, including nearly 200 offered by biopharmaceutical companies, helping Americans get free or reduced-cost prescription medicines. Co-pay assistance for pharmaceuticals.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
1331 F Street NW Ste 975
Washington, DC 20004
Phone: 202-347-9272
Organization Name: PAN Foundation
Address: 1331 F Street NW Ste 975
Washington, DC 20004
Phone: 202-347-9272
Email: contact@panfoundation.org
Eligibility: People with chronic or life-threatening illnesses, financial assistance for out-of-pocket costs.
Services Provided: Offers help and hope to people with chronic or life-threatening illnesses for whom cost limits access to breakthrough medical treatments.
Provider Profiles: Call or visit website.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
421 Butler Farm Road
Hampton, VA 23666
Phone: 866-512-3861
Organization Name: Patient Advocate Foundation
Address: 421 Butler Farm Road
Hampton, VA 23666
Phone: 866-512-3861
Toll Free Phone: 800-532-5274
Fax: 757-952-0119
Eligibility: Existence of insurance coverage for pharmaceuticals (including Medicare Part D coverage). Qualifying income. Qualifying diagnosis verified by physician of conditions such as breast, lung, lymphoma, prostate, kidney, colon, pancreatic, head/neck cancers, malignant brain tumor, sarcoma, diabetes, multiple myeloma, myelodysplastic syndrome (and other pre-leukemia diseases) osteoporosis, pain, hepatitis C rheumatoid arthritis, selected autoimmune disorders and CIA/CIN.
Services Provided: Co-pay assistance for pharmaceuticals.
Includes mental retardation and developmental disabilities.

Qualifying diagnosis verified by physician of conditions such as breast, lung, lymphoma, prostate, kidney, colon, pancreatic, head/neck cancers, malignant brain tumor, sarcoma, diabetes, multiple myeloma, myelodysplastic syndrome (and other pre-leukemia diseases) osteoporosis, pain, hepatitis C, rheumatoid arthritis, selected autoimmune disorders and CIA/CIN.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
Organization Name: National Alliance for the Mentally Ill (NAMI)
Address: 3803 N Fairfax Dr., Ste. 100
Arlington, VA 22203
Phone: 703-524-7600
Fax: 703-524-9094
Eligibility: Differs by specific pharmaceutical company.
Services Provided: Provides a list of pharmaceutical companies that offer medications through medication assistance programs to low-income individuals and families.
Provider Profiles: Internet-based resource
Original Source: MedHome Portal
Last Updated: 8/20/2018
Address: PO Box 5930
Midlothian, VA 23112
Phone: 800-366-7741
Toll Free Phone: 888-700-7010
Fax: 804-744-9388
Email: psiops@uneedpsi.org
Eligibility: Financial assistance for insured and uninsured patients with chronic illnesses. Assistance is focused on a limited number of around 20 diseases, and the list always changes.
Services Provided: Provides online disease and treatment information as well as limited financial assistance for patients with chronic illnesses who are struggling to keep up with expensive premiums and copayments. Available programs and specific illnesses are regularly updated. Financial assistance includes: subsidizing the cost of health insurance premiums; providing pharmacy and treatment copayment assistance; assisting with Medicare Part D co-insurance; providing travel assistance for transportation reimbursement.
Provider Profiles: Online resources
Original Source: MHP-Nationwide
Last Updated: 5/9/2019
127 Main Street 2nd Floor
Black Hawk, CO 80422
Phone: 888-670-0039
Address: 127 Main Street 2nd Floor
Black Hawk, CO 80422
Phone: 888-670-0039
Fax: 720-287-6523
Eligibility: Open to the public.
Services Provided: Helps consumers of prescription drugs save money at the retail pharmacy ranging from 10% to 85% depending on the type of drug you choose. Also offers valuable information on programs to help you with free medication through the Patient Assistance Partners.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
55 Kenosia Avenue
Danbury, CT 06810
Phone: 203-744-0100
Organization Name: National Organization for Rare Disorders
Address: 55 Kenosia Avenue
Danbury, CT 06810
Phone: 203-744-0100
Fax: 203-263-9938
Services Provided: Assistance programs to help patients obtain life-saving or life-sustaining medication they could not otherwise afford. Programs provide medication, financial assistance with insurance premiums and co-pays, diagnostic testing assistance, and travel assistance for clinical trials.
Original Source: Nevada 2-1-1
Last Updated: 5/14/2019
3171 Riverport Tech Center Drive
Maryland Heights, MO 63043
Phone: 877-727-9919
Address: 3171 Riverport Tech Center Drive
Maryland Heights, MO 63043
Phone: 877-727-9919
Fax: 800-875-6591
Email: questions@rxoutreach.org
Eligibility: Meet income guidelines.
Services Provided: Offers access to affordable medications through a mail order pharmacy for low income individuals and families.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 6/6/2019
Address:
Email: info@rxassist.org
Eligibility: Low income families
Services Provided: RxAssist offers a comprehensive database of prescription assistance programs, as well as practical tools, news, and articles so that health care professionals and patients can find the information they need. Directory of patient assistance programs for free and low cost medicine for low income families. Site requires free registration.
Provider Profiles: Internet Resource

Sponsored by ASTRA-ZENECA.
Original Source: MedHome Portal
Last Updated: 7/30/2018
Address:
Eligibility: Low-income. Eligibility guidelines may vary by the drug manufacturer.
Services Provided: Provides low-income US residents with information and free or low cost prescriptions through their health care professionals. This is an online service only. Addresses and telephone numbers will vary depending upon the specific drug and manufacturer desired.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 6/17/2019
71 Broadway, Unit 255
New York, NY 10006
Phone: 844-234-3057
Address: 71 Broadway, Unit 255
New York, NY 10006
Phone: 844-234-3057
Email: mcahilll@singlecare.com
Services Provided: Prescription discount cards to help those who are struggling to afford the medicine they need, and we're completely free to join. SingleCare partners with major pharmacies.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 5/13/2019
9700 Health Care Lane
PO Box 41
Minnetonka, MN 55343
Address: 9700 Health Care Lane
PO Box 41
Minnetonka, MN 55343
Toll Free Phone: 855-698-4223
Email: customerservice@uhccf.org
Eligibility: Parents of children receiving serious and financially-challenging health care treatment. 16 and under nationwide for medical services not covered or not fully covered by insurance. Live in US, covered by a commercial health insurance plan.
Services Provided: Provides grants, up to $5,000, for families who have children with critical healthcare treatment, services, or equipment not covered or not fully covered by their parents' health benefit plans to help pay for child health care services such as speech therapy, physical therapy, occupational therapy sessions, prescriptions, and medical equipment such as wheelchairs, orthotics, and eyeglasses. Co-pay assistance for pharmaceuticals.
Provider Profiles: See additional criteria and exclusions on website.
Original Source: Nationwide Suggest Providers Queue
Last Updated: 3/21/2019
Address:
Services Provided: Walmart is offering $4 prescriptions for some generic medications.
Original Source: MedHome Portal
Last Updated: 7/10/2018