Medicare Patient Assistant Programs (PAP)
If you have Medicare part D, there is a good chance you can qualify for a patient assistance program (PAP) that will cover the cost of your diabetes medications. The main requirement is that your income is below a certain threshold. This threshold is usually 300% or 400% of the federal poverty threshold (see table below), for which many retirees will fall under. Note that your savings and assets DO NOT COUNT AGAINST YOU! This is a common misconception amongst patients.
How do I find out if I am eligible for a PAP?
Find your medication in the table below. It will show the income cutoff. If you think you may qualify, clink the link to the PAP website. Download the PAP application and print it out. Carefully review the requirements and gather the required documentation (this usually includes proof of your income and sometimes receipts showing how much you have spent on medications so far this year). Once you have the required documentation, bring the form to your doctor to complete their portion. Have the doctor fax the form in, and you should get a decision within a couple weeks.
2021 Medicare Patient Assistance Programs
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Must have spent at least 2% of your annual hosehold income on prescription medications
Link to Sanofi Patient Connection
-
There is no patient assistance program for this medication, but there is a program to purchase teh medication directly from the manufacturer.
Link to Affrezza’s direct purchase program
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Must have spent at least 2% of your annual hosehold income on prescription medications
Link to Sanofi Patient Connection
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Lilly’s patient assistance program. On this site, click the link “check your eligibility”, then scroll down and click on “print application”
-
Requirements
Must either be a Medicare patient or uninsured
There is an income requirement, but it is not specified on the program website. It appears to be < 300% the federal poverty threshold ($38,280 or less for individuals, $51,720 or less for couples, or $78,600 for less for a family of 4)
Link to the AstraZeneca patient assistance program. On this site, scroll down and click “download an application”
-
Requirements
Must either be a Medicare patient or uninsured
There is an income requirement, but it is not specified on the program website. It appears to be < 300% the federal poverty threshold ($38,280 or less for individuals, $51,720 or less for couples, or $78,600 for less for a family of 4)
Link to the AstraZeneca patient assistance program. On this site, scroll down and click “download an application”
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level
($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Lilly’s patient assistance program. On this site, click the link “check your eligibility”, then scroll down and click on “print application”
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Lilly’s patient assistance program. On this site, click the link “check your eligibility”, then scroll down and click on “print application”
-
Unfortunately, there is no patient assistance program for this medication.
-
Requirements:
Must either be a Medicare patient or uninsured
household income must be < 300% the federal poverty level ($38,280 or less for individuals, $51,720 or less for couples, or $78,600 for less for a family of 4)
You must have spent 4% of your annual income on prescriptions.
Link to Johnson and Johnson’s patient assistance program. On this site, click the link “Patient assistance application form”.
-
Requirements:
Must either be a Medicare patient or uninsured
household income must be < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to the Merck patient assistance program. On this site, click the link “download enrollment form (application)”.
-
Requirements
You must have medicare part D insurance or be uninsured.
Household income must be <400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to the Boehringer Ingelheim website with the assistance program application. On the site, scroll down and click the link that says “flat form (print and fill out)”
If you are approved, the medication will be mailed directly to you.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Must have spent at least 2% of your annual hosehold income on prescription medications
Link to Sanofi Patient Connection
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Lilly’s patient assistance program. On this site, click the link “check your eligibility”, then scroll down and click on “print application”
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements
Must either be a Medicare patient or uninsured
There is an income requirement, but it is not specified on the program website. It appears to be < 300% the federal poverty threshold ($38,280 or less for individuals, $51,720 or less for couples, or $78,600 for less for a family of 4)
Link to the AstraZeneca patient assistance program. On this site, scroll down and click “download an application”
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Must have spent at least 2% of your annual hosehold income on prescription medications
Link to Sanofi Patient Connection
-
Unfortunately, there is no patient assistance program for this medication.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Must have spent at least 2% of your annual hosehold income on prescription medications
Link to Sanofi Patient Connection
-
Requirements
You must have medicare part D insurance or be uninsured.
Household income must be <400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to the Boehringer Ingelheim website with the assistance program application. On the site, scroll down and click the link that says “flat form (print and fill out)”
If you are approved, the medication will be mailed directly to you.
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements:
Must either be a Medicare patient or uninsured
household income < 400% the federal poverty level ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Lilly’s patient assistance program. On this site, click the link “check your eligibility”, then scroll down and click on “print application”
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
-
Requirements
Must either be a Medicare patient or uninsured
Household income must be < 400% the federal poverty threshold ($51,520 or less for individuals, $69,680 or less for couples, or $106,000 or less for a family of 4)
Link to Novo Nordisk patient assistance program. On the site, scroll down and click the link for the PAP application form that says “download now”.
If you are approved, the medication will be shipped to your doctor’s office for you to pick up.
Note that a new prescription needs to be sent in every 4 months by your doctor.
