What information do I need to enroll?

Last Updated: July 24, 2025

Getting started is simple. To begin your enrollment, just provide:

  • Your contact information
  • The name(s) of any medications that cost you more than $70/month
  • Your healthcare provider’s details (we’ll coordinate directly with them)
  • A payment method (you won’t be charged until you’re pre-qualified)

Once you submit your enrollment form, our team will contact you with your qualification status and next steps, including instructions for submitting income documentation, if required.

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