Rx Assistance Program

Option 1: PAP Forms

In 2007, 47 million U.S. residents lacked access to comprehensive healthcare coverage for services such as primary care physician visits, diagnostic services, pharmaceuticals, and specialty care physician access. Pharmaceutical manufacturers, retailers, and others have responded to this crisis through dedicated programs to serve those who cannot afford medications. These programs can be used to obtain hundreds of different medications, many times for free or at a highly reduced cost.

Find out if a medication is covered by a PAP program by following the steps listed below.

Step 1: The first step is to locate the appropriate PAP form through the RxAssist.org website.  While there are other locations where PAP forms can be searched,RxAssist.org is updated immediately with new PAP form programs and modifications to existing forms. In the rare event that the RxAssist.org website is down, please follow the same process at RxAssist.org.  

Step 2: Enter the patient's demographic, prescription, and income information into the PAP form.  When available, it may save time to enter the information through the RxAssist.org form wizard.  However, some forms may need to be printed and completed manually.  When given the option, always have the medication delivered to the patient directly.  If that is not possible, have the medication sent to the prescribing physician.  Never have medication delivered to the church, as all such medication will be disposed of and may not be dispensed to a visitor.

After the form is completed and if required, have the patient sign the PAP form. 

Step 3: Highlight all fields that the provider will need to complete (signature, provider number, etc.) and attach the appropriate information to the PAP form.  A list of required documentation can be found on the PAP form.  Typically income, identification, residency, and prescription information are all required. 

Step 4: After adding the required documentation copies to the completed PAP form, place the package into an envelope after attaching an explanation letter and a stamped envelope addressed to the manufacturer.   Mail each completed package to their respective prescribing physician's office.  
 
Steps 5 and 6: When received via mail, the physician's office will complete the open fields and sign the form. 

Step 7: From two to four weeks after application, the medication will arrive.  If the medication does not arrive within a month, the patient should contact the manufacturer by phone. 

Patient Education

Upon completion of the PAP form process, please educate the visitor on the following important issues:

It takes between two and six weeks for medication to be delivered.  The patient should make arrangements to secure their medication supply before the PAP form drugs arrive.
 
If at any time patients have questions about the status of their medication applications, they should contact the manufacturer.  It is a good idea to write down for the visitor the name of each medication applied for through a PAP form, manufacturer's name, and phone number. 
 
Many PAP form programs require reapplication at three-month or one-year intervals.  For that reason, the patient should either reserve a follow-up visit with a Neighborhood Rx Assistance Program volunteer at the appointment, or call two weeks before their medication runs out in order to re-apply.