Drugmaker Patient Assistance Programs: Free Prescriptions If You Qualify

2 hours ago

6 min read

Most big drugmakers run patient assistance programs that ship brand-name medicine free to people who can't afford it. The rules are strict and they changed for 2026, especially for people on Medicare. Here's how the programs work and how to put together an application that doesn't stall.

AT A GLANCE

What they are: programs, often run through a separate nonprofit foundation, that give a company's own brand-name medicines free to eligible patients.
Who usually qualifies: people who are uninsured or on Medicare (or other government coverage), with household income under a set multiple of the federal poverty level. People with job-based or other commercial insurance generally can't use them.
2026 changes: Pfizer now asks Medicare patients to enroll in the Medicare Prescription Payment Plan first; Novo Nordisk dropped some medicines and moved to online-only applications.
Your doctor has to take part: applications need a prescriber's section or signature.
They're free to apply for. Merck warns that outside groups charging a fee to fill out its forms don't act for Merck.

How these programs work

Patient assistance programs, or PAPs, aren't insurance. Each company covers only its own products, and each sets its own rules. Merck describes its program as a separate nonprofit 501(c)(3) corporation. Lilly Cares is a nonprofit that gives prescribed Lilly medicines free for up to 12 months to qualifying U.S. patients. Pfizer's program is run jointly by Pfizer and the Pfizer Patient Assistance Foundation.

Because the foundation is separate, the PAP is a different thing from a drug company's copay card. Merck says its PAP can't help with coupons or copays. Pfizer says people in Medicaid, Medicare or other government programs can't use its copay assistance, but may qualify for free medicine through the PAP.

A patient assistance program covers only one company's medicines, so the first step is finding out who makes each drug you take.

How three programs compare

Here's what each company's own pages said when we checked:

	Pfizer Patient Assistance Program	Novo Nordisk PAP	Merck Patient Assistance Program
Income limit	At or below 300% of the federal poverty level (pre-tax household income)	Medicare, insulins: at or below 400%; uninsured: at or below 200% for Ozempic, 400% for other medicines	Set per product; listed on each product page
Insurance	Uninsured or government-insured; commercial insurance not eligible	Medicare or no insurance; private or commercial insurance not eligible	People without prescription drug or health insurance coverage
Other requirements	Apply to other available funding first; Medicare patients enroll in the Prescription Payment Plan	Medicaid or Extra Help denial letter if you're eligible for those; U.S. citizen or legal resident	Form signed by patient and prescriber; income proof for some programs
How to apply	Enrollment form with proof of income; online for certain medicines via Pfizer PAP Connect	Online only, with patient and provider sections	Mail-in form to Merck PAP, PO Box 1206, Wilkes Barre, PA 18703-1206
Enrollment length	Not stated on the pages we checked	Uninsured: 12 months; Medicare: through the end of the calendar year	12 months; Medicare Part D: through the end of the calendar year
Phone	1-844-989-PATH (7284)	1-866-310-7549	1-800-727-5400, 8 a.m. to 8 p.m. ET weekdays

Lilly Cares can be reached at 1-800-545-6962. Its eligibility page couldn't be loaded when we checked, so call or ask your prescriber's office for the current rules.

What "300% of poverty" means in dollars

Programs measure income against the federal poverty guidelines. HHS's 2026 guidelines for the 48 contiguous states and D.C. are below, with the common PAP cutoffs worked out. Alaska and Hawaii have higher guidelines, and a program may use its own year's table, so treat these as estimates.

Household size	100% (2026 guideline)	200%	300%	400%
1	$15,960	$31,920	$47,880	$63,840
2	$21,640	$43,280	$64,920	$86,560
3	$27,320	$54,640	$81,960	$109,280
4	$33,000	$66,000	$99,000	$132,000

HHS adds $5,680 for each person beyond eight. At 300% or 400%, these limits reach well into working-household incomes, so check even if you don't think of yourself as low-income.

If you're on Medicare

The 2026 rules push Medicare patients toward Medicare's own help first.

Extra Help comes first. Extra Help is the Medicare program that lowers Part D premiums, deductibles and copays for people with limited income and resources. Medicare's 2026 limits are $23,940 in income and $18,090 in resources for an individual, and $32,460 and $36,100 for a married couple. Novo Nordisk requires Medicare patients under 150% of the poverty level to show an Extra Help denial for its insulin program, and a denial letter from anyone who's eligible. Our Extra Help guide explains how to apply.

Pfizer wants the Medicare Prescription Payment Plan. That's a free Medicare option that spreads your drug costs into monthly bills from your plan over the calendar year. Medicare says it doesn't lower your costs. For 2026, Pfizer requires Medicare Part D and Medicare Advantage patients asking for help with a covered Pfizer drug to enroll first and send proof, such as the plan's "Notice of Acceptance of Election." Missing proof stops the application for anyone with household income above 138% of poverty. On the form, you also attest that you know your monthly copay and annual out-of-pocket maximum ($2,100 for most Part D patients, per Pfizer), can't afford the copay, and haven't hit the maximum yet.

Some drugs left Novo's program. Novo Nordisk says Medicare beneficiaries with drug coverage can no longer get Ozempic through its PAP, because most Medicare plans cover it. Some other medicines also left the program for 2026; Novo posts the list of medicines still covered.

Enrollment runs with the calendar. Both Merck and Novo end Medicare enrollments on December 31, so plan to reapply each year.

How to apply without delays

List each brand-name drug and its maker. Your pharmacist can tell you who makes each one.
Find the program. Search the company name plus "patient assistance program," or call the company number. Pfizer's site links to NeedyMeds (1-800-503-6897), a nonprofit that tracks assistance programs.
Check your coverage path. If you could qualify for Medicaid or Extra Help, apply first. Novo requires the denial letter, and Pfizer may.
Gather income proof for the whole household. Pfizer lists a W-2, pay stub or the prior year's tax return. Novo asks for the last three pay stubs, a W-2 or 1099 if you didn't file taxes or had a life change.
Bring in your prescriber. Merck needs the prescriber's signature. Novo needs an email address for your provider's office so staff can complete their part online.
Submit and track it. Novo says complete applications are processed within 2 business days, with shipping within 5 business days of approval. Merck says complete forms are typically processed in under 7 business days, with medicine arriving in under 10 business days.
Set refill reminders. Merck ships most medicines as a 3-month supply and you must ask for refills. Its pharmacy dispenses within one day and ships by UPS.

If you don't qualify

Ask a community health center. HRSA lists health centers among the organizations that can buy outpatient drugs at reduced prices through the 340B program. Ask the center's pharmacy whether it offers lower prices to patients.
Ask about cheaper alternatives. A generic or a different drug in the same class may cost far less. Your prescriber can tell you if a switch is safe.
Look at nonprofit options. Pfizer's resource page points to Rx Outreach (1-855-796-4968), a nonprofit that supplies medicines at an affordable cost.
Check state programs. Some states run their own help, like Minnesota's insulin safety net.

Before you call

☐ The name, strength and maker of each medicine
☐ Your insurance card, or proof you're uninsured
☐ Last year's tax return, or recent pay stubs for everyone in the household
☐ Any Medicaid or Extra Help denial letter
☐ For Pfizer, proof you're enrolled in the Medicare Prescription Payment Plan
☐ Your prescriber's name, office phone, fax and email

WHAT TO DO THIS WEEK

Write down every brand-name drug you take and who makes it.
Call each company's assistance line and ask whether your medicine is in its program.
If you're on Medicare, check whether you qualify for Extra Help before you apply.
Ask your prescriber's office who handles patient assistance forms.

Related help

If a hospital or clinic bill is part of the same squeeze, see our guide to hospital charity care. If Medicare premiums are the problem, read about Medicare Savings Programs.

Official sources

Last checked: October 23, 2026 (Pfizer, Novo Nordisk, Merck and Lilly Cares program pages, HHS 2026 poverty guidelines, Medicare.gov Extra Help and Prescription Payment Plan pages, HRSA 340B page).

Companies can change or end these programs without notice. Novo Nordisk says so on its page. Confirm the rules with the company before you apply.