Patient Assistance Programs 101: Are You Eligible?

I’m going to let you in on a secret that most insurance companies and big pharmacies hope you never find out. There are programs designed to give you your medicine for free or next to nothing. They are called Patient Assistance Programs (PAPs), and they are funded by the very pharmaceutical companies that set those high prices.

But here is the catch: they make it incredibly hard to apply. It’s a maze of paperwork, income checks, and "red tape."

The Logic of PAPs

Why would a company like Eli Lilly or Novo Nordisk give away a $1,000 drug? It isn't just out of the goodness of their hearts. These programs help them manage their public image and meet certain tax and regulatory requirements. You can read more about how PAPs work here.

If the "list price" is $1,000, but they can get you to use a PAP, they avoid the "bad press" of someone going without life-saving medicine.

Who Actually Qualifies?

Most people assume these programs are only for the "destitute." That's wrong. Many PAPs have income limits that are surprisingly high—sometimes up to 400% or 500% of the Federal Poverty Level. For a family of four, that could be over $120,000 a year.

If you have a high deductible, or if your insurance denied your coverage, you are often eligible even if you have a decent job.

How to Get Through the Maze

The paperwork is the hurdle. They ask for tax returns, doctor signatures, and monthly updates. If you miss one deadline, they kick you out. That is where we come in. We are professional advocates. We handle the entire application, the follow-ups, and the renewals.

You pay us a $40 membership fee, and we ensure you stay enrolled so you never have to pay that $1,000 retail price again.

See if you qualify for free medications through our advocacy.