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Apply for assistance

Apply for patient financial assistance

Need help paying for treatments? We offer a fast, reliable way to get patient financial assistance. Apply for yourself or your patients today.

Get help with out-of-pocket costs

Our eligibility finder will determine if you are eligible for assistance, check for open funds, and provide additional resources if necessary.

More information about applying for patient financial assistance

Who qualifies for financial assistance?

To qualify for a financial assistance program, you (or the patient you’re applying for) must: 

  • Be getting treatment for the disease named in the assistance program, and
  • Be taking a medication that’s covered by your health insurance and listed in the assistance program, and 
  • Have an income that’s at or below the Federal Poverty Level listed by the assistance program, and
  • Live and receive treatment in the United States or U.S. territories. You don’t have to be a U.S. citizen.

What information do I need to apply as a patient?

You’ll need to provide your:

  • Diagnosis
  • Medication
  • Prescribing provider’s name and contact information
  • Health insurance carrier
  • Contact information, including email and Social Security Number
  • Adjusted gross annual household income