Disability Benefits 101: Working with a disability in California
Prescription Patient Assistance Programs: Frequently Asked Questions
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1) What is the Pharmaceutical Research and Manufacturers of America (PhRMA)?

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PhRMA represents American drug and biotechnology companies. They maintain a directoryOffsite Link that assists uninsured and underinsured individuals in finding Patient Assistance Programs (PAPs) that provide free or discounted prescription drugs. Requests for a hard copy of the PhRMA directoryOffsite Link can be made by calling (800) 762-4636.

2) What are Patient Assistance Programs (PAPs)?

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Drug companies offer Patient Assistance Programs (PAPs) to provide free or discounted prescription drug coverage to uninsured and underinsured people. These include Medicare and Medi-Cal beneficiaries and those who have private health insurance but lack adequate prescription drug coverage.

3) Are PAPs the same in all states?

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PAPs are neither federal nor state-run programs. They provide prescription drug assistance to individuals who qualify through pharmaceutical companies.

4) Who is eligible to participate in PAPs?

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For the most part, Patient Assistant Programs (PAPs) serve people who are either uninsured or underinsured. Some PAPs offer assistance to Medicare and Medi-Cal beneficiaries. Eligibility requirements for individual PAPs vary widely, so be sure to check each program before applying.

5) What do PAPs provide and how long will it last?

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Benefits for PAPs are not standardized. Some offer free or discounted prescription drugs for 3 months, while others offer benefits for 6 months. Many require an annual reassessment. Every program is different, so you should check with each PAP for an explanation of benefits.

6) Are there any medical eligibility requirements for PAPs?

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Depending upon the PAP, medical eligibility requirements may require you to have a specific diagnosis. Many PAPs, however, do not. Be sure to check with each PAP for specific medical eligibility requirements.

7) Does what I have in the bank and/or what I own, such as a home or car, affect my eligibility for PAPs?

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Sometimes. Many PAPs have financial eligibility requirements, while others do not. Because there are no standard financial eligibility requirements among PAPs, you should check with each program for financial requirements.

8) How do I prepare to apply for a PAP?

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Before applying for a PAP, you should gather the following information:
  • Age;
  • State of residence;
  • Estimated gross annual household income;
  • Name of prescription drugs; and
  • Type of health insurance and/or prescription coverage (if applicable).

9) How do I find a PAP that meets my needs?

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The Partnership for Prescription AssistanceOffsite Link has a PAP finderOffsite Link. You enter information about your situation, and the finder lists PAPs that you may be eligible for. DB101's Prescription Drug Coverage Resources section lists other websites that have PAP finders.

10) How soon after applying will I be eligible for benefits from a PAP?

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Each PAP has its own timeline for making prescription drug assistance available. Some programs deliver prescription drugs within 3-4 weeks, while others may take several months. It is best to check with each PAP to see when benefits will become available.

11) How do I stay enrolled in a PAP? How often do I have to reapply?

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To stay enrolled, you need to follow the requirements of that particular program. Many programs require you to reapply each time you need a prescription, while others require an annual application. Because PAPs are not standardized, you should check with the program for specific requirements.

12) Are there rules for immigrants to qualify for a PAP?

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Many PAPs require you to be either a U.S. resident or citizen. However, not all PAPs have residency requirements. It is best to check with each PAP for specific residency requirements.

13) What happens when I work while receiving benefits from a PAP?

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Most PAPs have requirements that are based upon insurance status. Unless a PAP has income requirements, working should have no effect on your eligibility for a program.

14) What else should I be aware of?

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Each PAP is different. You should check with each PAP in which you wish to participate for specific information on eligibility requirements and application procedures.
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http://www.disabilitybenefits101.org/ca/programs/health_coverage/prescription/phrma/faqs.htm