Patient Assistance Programs: Complete Guide

What Is a Patient Assistance Program?

A PAP is a program run by a drug manufacturer that provides brand-name medications at no cost to eligible patients. These are not discount cards or coupons — they are programs that ship free medication directly to your doctor’s office or a specialty pharmacy.

PAPs exist because manufacturers are required to provide access programs as part of their regulatory and tax obligations, and because providing free medication to low-income patients generates goodwill and keeps patients on their drugs (which benefits the company long-term).

Who Qualifies?

Eligibility varies by program, but most PAPs require:

• U.S. residency— Must be a legal U.S. resident (some programs accept non-citizens with valid prescriptions)
• Income below a threshold— Usually 200-500% of the Federal Poverty Level (FPL). For an individual in 2026, 200% FPL is about $31,300/year; 400% FPL is about $62,400/year; 500% FPL is about $79,800/year
• No adequate insurance coverage— Most PAPs require that you are uninsured, underinsured, or that the drug is not covered by your plan. Some accept Medicare patients in the coverage gap.
• Prescriber involvement— Nearly all PAPs require your doctor to submit the application or co-sign it

Key insight: Income limits are more generous than most people expect. A single person earning $62,000/year may qualify for programs with a 400% FPL threshold. A family of four earning $128,000/year may also qualify. Always check.

How to Apply: Step by Step

1. Find the right PAP. Use our savings tool— search your drug and we will show you the specific PAP with eligibility details, phone numbers, and URLs.
2. Check your income eligibility. Gather your most recent tax return or pay stubs. Income is usually measured as household Modified Adjusted Gross Income (MAGI).
3. Talk to your prescriber.Most PAPs require your doctor to complete part of the application. Some doctors’ offices have staff dedicated to PAP applications. Ask: “Does your office help patients apply for manufacturer assistance programs?”
4. Submit the application.Most can be done online, by fax, or by mail. You will typically need: proof of income, insurance status, a valid prescription, and the prescriber’s signature.
5. Wait for approval.Processing takes 2-4 weeks on average. Some programs (like AbbVie’s myAbbVie Assist) can process applications in 2 business days.
6. Receive medication.Once approved, medication is typically shipped to your doctor’s office or a designated specialty pharmacy. Some programs mail directly to patients.
7. Renew annually. Most PAPs require annual re-enrollment. Set a calendar reminder 30 days before your enrollment period ends.

Major PAPs by Manufacturer

This is not an exhaustive list. Search your specific medication in our drug database for detailed PAP information.

What If You Are Denied?

• Appeal the decision. Most programs allow appeals. If your income barely exceeds the limit, explain exceptional medical expenses that reduce your effective income.
• Ask about bridge supplies. Many PAPs offer a 30-day emergency supply while your full application is processed.
• Try independent foundations. Organizations like PAN Foundation, HealthWell Foundation, Patient Access Network, and NeedyMeds offer copay assistance independent of manufacturers.
• Check state pharmaceutical assistance programs (SPAPs). Many states run their own drug assistance programs with different eligibility criteria.
• Consider alternatives. Our savings tool shows generic alternatives, biosimilars, and other cost-saving options that may be more accessible.

Common Mistakes to Avoid

1. Not applying because you think you earn too much. Many PAPs have income limits at 400-500% FPL. A household earning $100,000+ may still qualify.
2. Applying without your doctor. Almost all PAPs require prescriber involvement. Submitting without it delays the process by weeks.
3. Forgetting to renew. PAP enrollment typically lasts 12 months. If you do not renew, your free medication stops abruptly.
4. Not asking for a bridge supply. If you cannot afford your medication while waiting for PAP approval, ask the manufacturer about emergency/bridge supply programs.
5. Ignoring other savings channels. A PAP may take 2-4 weeks to process. Meanwhile, copay cards, generics, or Cost Plus Drugs may provide immediate savings.

PAPs and Medicare: What Changed in 2026

The 2026 Part D changes have affected PAP eligibility for Medicare patients. With the new $2,000 OOP cap, some manufacturers have tightened Medicare PAP eligibility, arguing that the cap provides sufficient protection. However, several programs still accept Medicare patients:

• BMS PAF (Eliquis) — still accepts Medicare patients with high Rx spending
• myAbbVie Assist (Humira, Skyrizi, Rinvoq) — still accepts Medicare
• Merck PAP (Keytruda) — still accepts Medicare in coverage gap

For the most current Medicare PAP eligibility, search your drug in our savings tooland select “Medicare” as your insurance type.