How to Use Patient Advocacy Foundations for Medication Grants

Getting the medication you need shouldn’t mean choosing between paying rent or filling your prescription. For millions of Americans, even with insurance, out-of-pocket costs for life-saving drugs can be overwhelming. That’s where patient advocacy foundations come in - they’re nonprofit organizations that step in when insurance falls short and pharmaceutical companies won’t cover everything. These foundations don’t just offer hope. They give real, direct financial help to get you the meds you need.

What Exactly Do Patient Advocacy Foundations Do?

Patient advocacy foundations like the Patient Advocate Foundation (PAF) provide grants to help cover the cost of medications. They’re not insurance. They’re not government programs. They’re nonprofit lifelines funded by donations, pharmaceutical partnerships, and charitable contributions. Their main goal? To make sure no one skips doses or stops treatment because they can’t afford it.

PAF, founded in 1996, runs two major programs: Financial Aid Funds and the Co-Pay Relief Program. The Co-Pay Relief Program is for people who have commercial health insurance but still face high co-pays, coinsurance, or deductibles. For example, if your insulin costs $500 a month and your insurance only covers $300, PAF might pay the remaining $200. The Financial Aid Funds are for people who are uninsured, underinsured, or need help with non-medication costs like travel to treatment centers or lab fees.

These aren’t vague promises. PAF has distributed over $1 billion in financial assistance since its founding. That’s real money going straight to pharmacies and providers to cover real prescriptions.

Who Qualifies for These Grants?

Eligibility isn’t based on being poor - it’s based on being stuck. You don’t need to be on Medicaid. You don’t need to be unemployed. You just need to be in active treatment for a serious condition and struggling to pay.

Here’s what you need to qualify for PAF’s programs:

• A confirmed diagnosis of a serious or chronic health condition - like cancer, multiple sclerosis, rheumatoid arthritis, or thyroid eye disease.
• You’re currently in treatment, starting treatment within the next 60 days, or finished treatment within the last six months.
• You’re a U.S. citizen or permanent resident receiving care in the U.S. or a U.S. territory.
• For the Co-Pay Relief Program: you must have commercial insurance (not Medicare or Medicaid) for the specific medication you need help with.
• You meet income guidelines, which vary by condition and fund. For most programs, annual income must be under 500% of the federal poverty level - that’s about $68,000 for a single person in 2025.

Some funds have extra rules. For example, the Sepsis/ARDS/TSS fund requires your application to be submitted within six months of diagnosis. The Thyroid Eye Disease fund only helps with specific medications approved for that condition. Always check the exact requirements for your disease.

How to Apply - Step by Step

Applying feels overwhelming, but it’s simpler than you think. Here’s how to do it right:

1. Find the right fund. Go to patientadvocate.org and click on "Financial Aid Funds" or "Co-Pay Relief." Use the search tool to find your condition. If you have multiple medications, you may qualify for more than one fund.
2. Gather your documents. You’ll need:

• Proof of diagnosis - a letter or form from your doctor confirming your condition and treatment plan.
• Proof of income - your most recent tax return, pay stubs, or a signed statement if you’re unemployed.
• Proof of insurance - a copy of your insurance card and a recent explanation of benefits (EOB) showing your out-of-pocket costs.
• Proof of residency - a utility bill or lease agreement.

3. Get your doctor involved. Your provider must complete a form verifying your diagnosis, treatment, and need for the medication. This isn’t optional. Without it, your application won’t move forward.
4. Submit your application. You can apply online through the PAF portal or call the dedicated number for your condition. For Co-Pay Relief, go to copays.org. For other funds, use these numbers:

• General assistance: 844-974-0257
• Sepsis/ARDS/TSS fund: 855-824-7941
• Caregiver Support (with American Cancer Society): 844-462-8072

4. Wait for approval. If you qualify, you’ll get a letter within 5-10 business days. Grants are paid directly to your pharmacy or provider - never to you. That means you won’t have to front the money.

What Happens After You Apply?

Don’t assume approval is guaranteed. Funding runs out - fast.

Many condition-specific funds are donor-funded and operate on a first-come, first-served basis. Once the monthly budget is used up, applications close until the next month. For example, the fund for pulmonary hypertension might open on the first business day of each month with $100,000. If 150 people apply and only $80,000 is left, the rest are turned away - even if they qualify.

That’s why timing matters. Apply early in the month. Don’t wait until the 25th. Check the fund’s status page on PAF’s website - it often shows how much money remains.

If your application is denied or funds are exhausted, don’t give up. Reapply the next month. Some people get approved after three or four tries. PAF also offers free case management services. A patient advocate can help you understand your insurance, appeal denials, or find other resources.

How PAF Compares to Other Options

You might be wondering: Why not just use a pharmaceutical company’s patient assistance program (PAP)?

Here’s the difference:

Comparison of Patient Assistance Options

Option	Best For	Funding Source	Coverage	Limitations
Patient Advocate Foundation (PAF)	Insured patients with high co-pays, or uninsured patients needing broad financial help	Donor-funded, multi-pharma partnerships	Multiple medications, non-medical costs (travel, labs)	Funds deplete quickly; first-come, first-served
Pharmaceutical PAPs	Uninsured patients needing one specific drug	Drug manufacturer	Free medication for one brand-name drug	Only covers one drug; often requires proof of no insurance
Medicare Part D Extra Help	Seniors with low income	Government	Coverage for most Medicare Part D drugs	Only for Medicare beneficiaries; strict income limits
State Prescription Assistance Programs	Residents of specific states	State government	Varies by state - may cover generics or specific drugs	Only available in certain states; limited funding

PAF is unique because it helps people who fall through the cracks. If you have insurance but your deductible is $7,000 and your monthly co-pay is $400, a pharmaceutical PAP won’t help you - they only serve the uninsured. PAF does.

What to Do If You’re Denied or Funds Run Out

It happens. More than half of applicants who apply late in the month get turned away simply because the money’s gone. That doesn’t mean you’re not eligible. It means you need to be strategic.

• Apply early. The first three days of the month are your best shot.
• Apply to multiple funds. If you take three different medications, check if each has its own grant program.
• Call PAF’s case management line. Sometimes they can connect you to local charities, hospital financial aid, or drug discount cards.
• Ask your doctor about alternatives. Is there a generic version? A different drug in the same class that’s cheaper? Sometimes a small switch makes a big difference.
• Check GoodRx or NeedyMeds. These sites list discounts, coupons, and other assistance programs you can use while waiting for grant approval.

Why This Matters - And Why It’s Getting Harder

Prescription drug prices have risen 55% since 2014, according to AARP. In 2025, nearly 30 million Americans are still uninsured. Another 40 million are underinsured - meaning they have coverage, but not enough to cover their meds.

Patient advocacy foundations like PAF are the last line of defense. Without them, people choose between their health and their rent. Between their child’s insulin and their own groceries. Between living and dying.

These programs aren’t perfect. Funding is unpredictable. The system is fragmented. But they work - for thousands of people, every single month.

Frequently Asked Questions

Next Steps - What to Do Today

If you’re struggling to afford your medication:

• Visit patientadvocate.org right now.
• Search for your condition in the Financial Aid Funds directory.
• Print out the eligibility checklist and gather your documents.
• Call your doctor’s office and ask them to start the required form.
• Apply before the 5th of the month - don’t wait.

This isn’t charity. It’s access. You’ve paid into the system. You’ve followed the rules. You deserve to get the medicine you need - without going broke to do it.