Co-Pay Relief Program

thru: Patient Advocate Foundation

• Operating as an independent division within PAF, offering a program that provides direct financial assistance with co-payments, co-insurance and deductibles required by insurer for pharmaceutical treatments and/or prescription medications relative to diagnosis. In some cases, medical insurance premium is also available.

Language Access

Eligibility: Insured and have coverage for medication. Reside and receive treatment in the United States. May Financially qualify for Household income guidelines ranging from 400-500% of the federal poverty level to meet the Cost of Living Index.

Application Process: Accepting applications daily. online service for patients, providers and pharmacies available 24 hours a day. Assistance by phone.

Required Documentation: Signed, completed application, physician Form, completed and signed by your treating physician. Copy of signed federal tax return from most recent tax year (pages 1 & 2 only). In the case that you are unable to provide a federal tax return from most recent year, we can consider alternate documents to verify your income.

Fees: No fee for services.

Coverage Note: United States.

Languages: Spanish- Language line