Patient Assistance Program Application, How to Get it, Hints and Tips

These days, getting medications is not an easy task.

Worse yet, with the increasing cost of living, not everyone may be able to afford their medications. Worse yet, many Americans cannot afford medical coverage or health insurance that cover the cost of their prescriptions. Thankfully, a Prescription Assistance Program can help.

What Is a Patient Assistance Program (PAP)? A Patient Assistance Program, commonly referred to as a PAP, is a program offered by pharmaceutical manufacturers aimed at helping people who can’t afford their needed medications get them at zero or very low cost.

However, the process and eligibility requirements to get into these programs vary from one company to another.

Typically, pharmaceutical companies offer PAP’s with two main objectives. One is to establish a corporate social responsibility by helping people who can’t afford their meds. The second is to build marketing exposure for attracting customers.

Now that we have the basics, let’s get into the details.

 

How Patient Assistance Programs Work

PAP’s are designed to help those in need by identifying patients unable to afford their medical expenses and providing them their medications at no cost.

However, every pharmaceutical manufacturer follows their own guidelines, procedures, processes, rules, and regulations. This means the manufacturer of the medication determines the eligibility criteria as well as how long the person can receive assistance.

 

Learn About Patient Assistance Programs

You may wish to seek out your healthcare provider for more information. While we highly recommend you do, there is a small catch. Unfortunately, many healthcare providers do not know that Patient Assistant Programs exist!

However, our expertise is in the Patient Assistant Program field. Contacting us here at Prescription Hope will not only help answer your questions, but can simply the Patient Assistance Program process for the set price of $60.00 per month for each medication. Our medication access service handles all the details during the process, giving you peace of mind and a reliable advocate with the pharmaceutical manufacturers.

Sadly, most who research Patient Assistance Programs may find which pharmaceutical companies offer programs and which do not, as well as an overview of how their PAP works according to their procedures. But getting a complete consultation based on your specific circumstances is often difficult and complex.

Instead, simply contact us so we can answer any questions you may have concerning the PAP enrollment process. We keep up-to-date on all eligibility requirements set by each pharmaceutical manufacturer, as well as any changes in medication availability.

 

How To Get Medications Through PAP’s

You can enroll for a PAP with most pharmaceutical manufacturers. Although, programs differ from company to company.

However, one common trait with PAPs is the need to file an application form to enroll. The application form requires in-depth information, yet the questions will vary from company to company. Some patient assistance program applications may be online, but most are paper applications. Here at Prescription Hope, our medication access service handles the intricacies of the various pharmaceutical manufacturer’s enrollment forms. We have a simple online form that we then use to enroll you into any needed PAP.

Each PAP requires medical information, prescription information, identifying information, and a healthcare provider’s signature to authorize the medication for the patient. Even with all that is requested from you, some companies will even require your healthcare provider to fill out sections of the form as well.

Prescription Hope will contact your healthcare provider and work with them to complete the necessary paperwork to order your medication from the manufacturer.

When it comes time to receive your medication, different companies have different methods. Some companies send the medication to your home, whereas some companies send the listed medications to your healthcare provider’s office for distribution. Occasionally, some pharmaceutical companies will send the medication to your pharmacy. If one is getting medications from a pharmacy after enrolling into this specific patient assistance program, they may have to present a printed certificate or a card to the pharmacist.

Unfortunately, the process can become even more complex. Some patients who need continued medications may not be able to do so, because not all programs covering medications for chronic diseases offer the option of refilling. 

Simplifying this process is easy to do. Take a few minutes and enroll in Prescription Hope’s medication access service, offered here. Once we receive your application, we will see if you qualify for any existing patient assistance programs for the medication you applied for. If you qualify, we will reach out to you for income documentation and reach out to your healthcare provider for prescription information. Once we receive that back from you and your healthcare provider, we will then order the medication directly from the U.S. based pharmaceutical manufacturers patient assistance program that offers your medication. After the initial fill, we will also place refills going forward so that you never run out of medication.

 

Associated Costs In Patient Assistance Programs

PAP’s are programs for the financially needy and so there are no real negative costs in participating in such program. However, the time and energy spent in applying for various PAPs can be stressful and disheartening.

Our mission at Prescription Hope as a medication access service is to give our members peace of mind concerning their medications. We desire to be your medication advocate every step of the way. From start to finish.

With that, let’s take a look at the enrollment process. This can help you decide if you want to enroll by yourself or through Prescription Hope’s medication access service.

The Enrollment Process

Although there’s no standard enrollment process for every company, most of the PAP’s require the patient, healthcare provider or both to fill out an application form. Some pharmaceutical companies have a standard form applicable to all medical needs. Whereas some pharmaceutical companies require a separate application form for each drug. Thankfully, we at Prescription Hope handle all these variables, so you don’t have to.

Below is some common information requested for the application process for Prescription Assistance Programs.

• The patient’s information regarding the medical condition that needs assistance. The diagnosis of the medical need will have to be documented by the nurse, healthcare provider, treating physician or patient’s advocate.
• The health and drug insurance coverage to show that the patient does not have prescription drug coverage. This will also confirm that the patient does not qualify for any other private or public health insurance (such as Medicare or Medicaid). In most of the PAP’s, patients who have health insurance and no prescription coverage are considered eligible for the program.
• Patients with Medicare have different eligibility criteria, however, these patients should operate “outside the Part D benefit”. Some pharmaceutical companies offer this program to Medicare beneficiaries who don’t have supplemental drug coverage. Others may deny patients with eligibility for other drug benefits from any public assistance program. This may include programs offered by the state and other local programs.
• The enrollment process typically requires the household income to be documented with a W-2 form, income tax returns and/or bank statements.
• Once approved, the patient’s prescription medication is then sent to the provider’s office or a local pharmacy for the purpose of distribution.
• All the patients enrolled under a program receive anywhere between a 30-180-day supply of their medication.
• When patients require a refill, most of the PAP’s will require them to submit a new application.

Keep in mind, these are just some of the requirements during the PAP enrollment process.

Meanwhile, you could enroll with us to see if your medication is covered.

 

What Medications Are Covered

Each year, the pharmaceutical companies decide what medications should be covered under a PAP. Some companies include almost all of the medications they manufacture, whereas some offer only a few. Some companies also sell generic medications at a fixed price.

The availability of certain medications changes periodically. This means that certain dosage limits of meds could be available now and then may cease to be carried by a PAP. Unfortunately, information on the selection process is not available to the public.

 

Benefits Of Patient Assistance Programs

While differences between programs exist, there are some common benefits of Prescription Assistance Programs.

1. Coupons: These are discount coupons that patients can redeem directly with a participating pharmacy or the suppliers.
2. Direct discounts at your pharmacy: Patients enrolled in discount programs get access to a direct discount from the pharmacy at the point of purchase.
3. Free product: Supplies are directly shipped free of charge to the program participant.

However, these benefits as an overall can be limited based on the participating individual’s needs and resources. Some patients receive a full benefit of 100% discount on their medication while some patients may receive much lower discounts. 

 

Tips For Easy Enrollment

One of the most common problems a patient encounters when applying for Prescription Assistance Programs is the lack of physician cooperation. Many patients have continuously faced physicians who do not cooperate due to the time required to fill out the required forms.

Here are a few tips to overcome such an obstacle:

1.   Make sure you fill out the form as much as possible. Do not just limit it to the applicant’s section of the form, read it carefully so you understand it and see anything else you can fill in. This may include details like the physician’s name and address, phone number, etc.
2.   Make sure you take with you all documentation the healthcare provider may require to fill in the form. This makes the signature process simpler for them. Some programs may require proof of income, identity and so on.
3.   Bring an addressed envelope with the appropriate postage.
4.   Give your healthcare provider some time to fill out the form accurately.  A busy healthcare provider may not be able to complete the form immediately. In fact, your healthcare provider may not have the time to read and fill the form when you’re in the office. So make sure you give him or her sufficient time. 
5.   If you experience a long delay or resistance from the healthcare provider, then gently explain your needs and your financial condition. Help them understand why you need to enroll in the program. Remind them that without their help, you cannot enroll for the program and your health may suffer as a result.
6.   If all your efforts fail in getting the healthcare provider signature, then you may have to find a physician who is more sympathetic.
7. Sign up with Prescription Hope. We can take care of the entire process for you, and all we require to get started is one simple online application.

Lastly, remember that PAP’s help financially unstable patients obtain a better quality of health through medical assistance. As such, your healthcare provider may need to make a fair assessment of whether or not to sign the forms.

To Finish

We hope this has been useful in understanding more about Patient Assistance Programs and how they could help you. While the process is often complex and difficult, there is an easier way. Get started enrolling with Prescription Hope, and we’ll do our best to help you get access to the medications you need. If you have any questions about saving money on your medications, or you’re having trouble affording any of the medications you’ve been prescribed, contact us, or visit us online to learn more, we’re happy to help.