If you cannot afford a prescription, a patient assistance program (PAP) may give you the medication free or nearly free. As of 2026, more than 180 pharmaceutical manufacturers operate PAPs covering over 2,500 brand-name medicines. Programs are income-based, and income thresholds often run as high as 400% of the Federal Poverty Level, which means many working adults qualify, not just the very poor.
Quick Answer: Patient assistance programs are manufacturer-sponsored programs that provide brand-name medications at no cost to uninsured or underinsured people who meet income requirements. In 2026, most PAPs require household income at or below 200% to 400% of FPL and no private or government drug coverage for the specific medication. Apply directly through the manufacturer website or search NeedyMeds.org or RxAssist.org by drug name.
This guide covers the PAP landscape for the top 50 most-prescribed drugs in America, including specific income limits for the biggest programs, what documents you need, and a step-by-step process to get approved.
What Is a Patient Assistance Program?
A patient assistance program is a drug company's free-medicine benefit for patients who cannot afford their prescriptions. The manufacturer ships the medication either directly to your home or to your doctor's office, with no copay and no shipping fee in most cases. PAPs are separate from Medicare Extra Help, Medicaid, and coupon cards. They are the option of last resort for people who do not qualify for those programs or who need help with a medication those programs do not cover.
Key features of 2026 PAPs:
- Run by the brand-name drug maker, not the government
- Cover brand-name drugs (not generic versions)
- Require a prescription from a licensed U.S. physician
- Generally require proof of income, U.S. residency, and lack of adequate drug coverage
- Take 2 to 6 weeks to process
- Can be renewed annually
PAPs do not replace health insurance. They cover the specific drug, not doctor visits, lab work, or other treatments. If you also need coverage for those costs, check your eligibility for Medicaid or an ACA marketplace plan at CoveredUSA's free screener.
Who Qualifies for Patient Assistance Programs in 2026?
Requirements vary by manufacturer and drug, but four criteria appear across virtually every PAP:
- U.S. residency. You must live in the United States or a U.S. territory.
- Valid prescription. Your physician must prescribe the medication for an FDA-approved indication.
- Income below program threshold. Most programs require 200% to 400% of FPL. Some go higher for specific conditions.
- No adequate coverage for that drug. You may not have private insurance that covers the medication, may not be on Medicaid, and may not qualify for Medicare Extra Help (LIS) for the same drug.
AbbVie's myAbbVie Assist program adds one extra step for Medicare Part D enrollees: if you have Part D, you must first be denied Medicare Extra Help (Low Income Subsidy) before AbbVie will consider you. Check the current Extra Help income threshold at medicare.gov to see if you're in this situation.
2026 Federal Poverty Level Reference (used by all PAPs)
All income thresholds below are based on the 2026 Federal Poverty Level published by the Department of Health and Human Services at aspe.hhs.gov.
| Household Size | 100% FPL (2026) | 200% FPL | 300% FPL | 400% FPL |
|---|
| 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 |
| 5 | $38,680 | $77,360 | $116,040 | $154,720 |
| 6 | $44,360 | $88,720 | $133,080 | $177,440 |
| 7 | $50,040 | $100,080 | $150,120 | $200,160 |
| 8 | $55,720 | $111,440 | $167,160 | $222,880 |
| Each additional | +$5,680 | +$11,360 | +$17,040 | +$22,720 |
Source: HHS 2026 Poverty Guidelines. All figures are approximate annual household income.
PAPs for the Top Drugs by Manufacturer
Below are the PAP details for the medications that account for the largest share of U.S. prescriptions and spending in 2026. For drugs with generic equivalents, note that PAPs only cover the brand; generic programs like GoodRx or the manufacturer's own savings card often make more sense for insured patients who simply want a lower copay.
Pfizer RxPathways
Covers: Eliquis (apixaban), Lyrica, Xeljanz, Inlyta, Ibrance, and dozens of other Pfizer brand medicines.
2026 income limit: Annual household pre-tax income at or below 300% of FPL. A single person must earn under $47,880; a family of four must earn under $99,000.
Insurance requirement: Uninsured only, or government-insured and unable to afford the copay. Patients with commercial (employer or marketplace) insurance are not eligible.
Apply: pfizerrxpathways.com
myAbbVie Assist
Covers: Humira (adalimumab), Skyrizi, Rinvoq, Imbruvica, Mavyret, Venclexta, and other AbbVie products.
2026 income limit: Not publicly published as a fixed dollar amount; AbbVie evaluates based on financial need and lack of adequate coverage. In practice, applicants below 400% FPL with no commercial insurance coverage for the specific drug routinely qualify.
Medicare Part D requirement: If you have Part D, you must provide proof that you were denied Medicare Extra Help before AbbVie will evaluate you.
What you receive: Free medication, no copays, no shipping costs.
Apply: abbvie.com/patients/patient-support/patient-assistance.html
Novo Nordisk NovoCare PAP
Covers: Ozempic (semaglutide), Victoza, Rybelsus, Tresiba, NovoLog, and other Novo Nordisk products.
2026 income limits:
| Drug | Income Limit | Single | Family of 4 |
|---|
| Ozempic (semaglutide) | 200% FPL | $31,920 | $66,000 |
| All other Novo Nordisk products | 400% FPL | $63,840 | $132,000 |
Insurance requirement: Uninsured or Medicare (no private or commercial insurance). Medicaid patients, patients with Medicare Extra Help, and VA benefits enrollees are not eligible.
Apply: novocare.com/diabetes/help-with-costs/pap.html
Lilly Cares Foundation
Covers: Trulicity, Mounjaro, Humalog, Jardiance (co-developed with BI Cares), Verzenio, Cymbalta, and other Eli Lilly products.
2026 income limit: Evaluated case by case based on income and insurance status; Lilly Cares is a registered nonprofit that funds the program and generally aligns with the 400% FPL ceiling.
Apply: lilly.com or call 1-800-545-5979 (Lilly Cares Foundation)
Sanofi Patient Connection
Covers: Lantus, Toujeo, Dupixent, Praluent, Kevzara, and other Sanofi brands.
2026 income limit: Publicly available financial eligibility tiers at sanofipatientconnection.com/financial-eligibility. The standard threshold is below 400% FPL; Dupixent has its own separate program.
Merck Helps
Covers: Keytruda (pembrolizumab), Januvia, Janumet, Gardasil, Belsomra, and other Merck medicines.
Apply: merckhelps.com
BI Cares (Boehringer Ingelheim)
Covers: Jardiance, Tradjenta, Ofev, Spiriva, and other BI products.
2026 income limit: Household income at or below 400% FPL.
Bristol Myers Squibb Access Support
Covers: Opdivo, Eliquis (co-marketed with Pfizer; both companies run separate programs), Orencia, Revlimid.
Note: Eliquis is co-marketed by Pfizer and BMS. Both run PAPs. Apply to whichever matches your situation.
Top Drugs With PAPs: Quick-Reference Table (2026)
| Drug (Brand) | Generic Name | Condition | Manufacturer PAP | Income Limit |
|---|
| Ozempic | semaglutide | Type 2 diabetes / weight | NovoCare | 200% FPL |
| Humira | adalimumab | Arthritis, Crohn's, psoriasis | myAbbVie Assist | Need-based |
| Eliquis | apixaban | Atrial fibrillation, clotting | Pfizer RxPathways / BMS | 300% FPL |
| Keytruda | pembrolizumab | Cancer | Merck Helps | Need-based |
| Dupixent | dupilumab | Eczema, asthma | Sanofi Patient Connection | Need-based |
| Jardiance | empagliflozin | Type 2 diabetes, heart failure | BI Cares | 400% FPL |
| Skyrizi | risankizumab | Psoriasis, Crohn's | myAbbVie Assist | Need-based |
| Rinvoq | upadacitinib | Arthritis, eczema | myAbbVie Assist | Need-based |
| Trulicity | dulaglutide | Type 2 diabetes | Lilly Cares | Need-based |
| Mounjaro | tirzepatide | Type 2 diabetes / weight | Lilly Cares | Need-based |
| Lantus | insulin glargine | Diabetes | Sanofi Patient Connection | 400% FPL |
| Victoza | liraglutide | Type 2 diabetes | NovoCare | 400% FPL |
| Ibrance | palbociclib | Breast cancer | Pfizer RxPathways | 300% FPL |
| Xeljanz | tofacitinib | Arthritis | Pfizer RxPathways | 300% FPL |
| Opdivo | nivolumab | Cancer | BMS Access Support | Need-based |
| Spiriva | tiotropium | COPD | BI Cares | 400% FPL |
| Ofev | nintedanib | IPF, lung disease | BI Cares | 400% FPL |
| Lyrica | pregabalin | Nerve pain, fibromyalgia | Pfizer RxPathways | 300% FPL |
| Januvia | sitagliptin | Type 2 diabetes | Merck Helps | Need-based |
| Gardasil | HPV vaccine | HPV prevention | Merck Helps | Need-based |
Note: Most of the top 50 most-prescribed medications are generics (atorvastatin, lisinopril, metformin, levothyroxine, etc.). Generics are usually available for under $10 per month at pharmacies or free at programs like Mark Cuban's Cost Plus Drugs (costplusdrugs.com). PAPs are most valuable for brand-name specialty medications that have no generic alternative.
Where to Search for PAPs You Did Not Know Existed
NeedyMeds.org
The most comprehensive free database of drug assistance programs in the United States, covering over 5,000 programs. Search by drug name to see every available PAP, including state pharmaceutical assistance programs and disease-specific nonprofit programs. Contact: 1-800-503-6897 or info@needymeds.org.
RxAssist.org
A directory maintained by Volunteers in Health Care that lists PAPs by manufacturer and drug name. Provides direct application links and program summaries.
PhRMA's helpingpatients.org
The pharmaceutical industry's own directory of member-company PAPs at helpingpatients.org.
CMS PAP Database
The Centers for Medicare and Medicaid Services maintains a list of manufacturer PAPs at cms.gov, which is useful if you are on Medicare and want to check whether a manufacturer is approved to operate a PAP for Part D drugs.
How to Apply for a Patient Assistance Program
Applications are submitted directly to the drug manufacturer, not to the government. Most programs follow the same structure.
Enrollment window: PAPs are available year-round. There are no open enrollment periods. Approvals are typically valid for 12 months and must be renewed.
Step-by-step application process:
- Identify the manufacturer. Look at your prescription bottle or the drug label. The brand name is the starting point. If unsure, search the drug name on NeedyMeds.org.
- Go to the manufacturer's PAP page. Use the links in the tables above or search "[brand name] patient assistance program."
- Complete the patient section of the application. You will enter your name, address, date of birth, household income, household size, insurance status, and the specific medication.
- Have your doctor complete the physician section. Most programs require your prescriber to certify the prescription and medical need. Give your doctor the application in person or ask the program to send an email request to your physician on your behalf.
- Gather and attach required documents. (See checklist below.)
- Submit the completed application. Most programs accept online submission or fax. Mailed paper applications are accepted but slow.
- Wait for approval. Processing takes 2 to 6 weeks. Some programs have expedited pathways for urgent medical needs. If you are approved, your medication will be shipped to your home or physician's office.
Documents you will need:
- Proof of income (most recent federal tax return, or pay stubs from the last 2 months, or W-2)
- Proof of U.S. residency (driver's license, utility bill, lease agreement)
- Valid prescription from your doctor
- Proof of insurance status or denial (explanation of benefits, Medicare card, or denial letter from Medicare Extra Help if required)
- Government-issued photo ID
Common reasons applications get denied:
- Income exceeds the program threshold (check the FPL table above and recalculate)
- You have private commercial insurance that covers the medication (even partially)
- You are enrolled in Medicaid for the state where the drug would be covered
- Application was submitted without the physician section completed
- Proof of income was missing or insufficient (a bank statement alone is usually not accepted)
State Pharmaceutical Assistance Programs (SPAPs)
Many states operate their own drug assistance programs that work alongside PAPs or Medicare Part D. These are especially common for seniors. Notable 2026 SPAPs include:
- New Jersey PAAD (Pharmaceutical Assistance to the Aged and Disabled): For NJ residents age 65 and older or receiving Social Security Disability, with income below state limits. Apply at nj.gov/humanservices/doas/services/l-p/paad/.
- New York EPIC (Elderly Pharmaceutical Insurance Coverage)
- Pennsylvania PACE/PACENET
- Connecticut ConnPACE
- Illinois Circuit Breaker
State programs vary significantly in income limits, eligible drugs, and enrollment requirements. NeedyMeds.org maintains a current SPAP database searchable by state.
PAPs and Medicare: What You Need to Know
If you have Medicare Part D, PAP eligibility gets complicated. Under current CMS rules, manufacturer PAPs generally cannot provide free medications to Medicare Part D enrollees for covered Part D drugs, because that would be considered inducement. However, exceptions exist:
- If a drug is not covered under your Part D plan, you may use the manufacturer PAP.
- If you are below 150% FPL and have been denied Medicare Extra Help, some manufacturers (AbbVie is the clearest example) will still evaluate you for their PAP.
- Some manufacturers operate separate "copay assistance" programs for Medicare patients that reduce cost-sharing without providing free drugs.
For a complete breakdown of Medicare prescription cost-saving options, see medicare.gov's drug cost help page.
If you also have general coverage questions, including whether you qualify for Medicaid, Medicare Savings Programs, or ACA marketplace plans, check your eligibility at CoveredUSA in about 2 minutes. It is free and confidential.
How to Apply: Next Steps
Check your eligibility now at CoveredUSA, it takes 2 minutes. If you or someone in your household also needs health coverage (not just drug assistance), the CoveredUSA screener shows every program you may qualify for based on your age, income, and state.
For prescription assistance specifically, start with these three steps:
- Search your drug name on NeedyMeds.org or RxAssist.org to find every available program.
- Visit the manufacturer's PAP website directly and download or start the online application.
- Bring the physician section to your doctor at your next appointment or ask the program to contact your doctor by email.
Frequently Asked Questions
What is the income limit for patient assistance programs in 2026?
Income limits vary by manufacturer and drug. The most common thresholds as of 2026 are 200% FPL (roughly $31,920 for a single person or $66,000 for a family of four) and 400% FPL (roughly $63,840 for a single person or $132,000 for a family of four). Some programs set even higher limits for specialty or cancer medications. Use the FPL table in this article to check whether your income falls under the program limit for your specific drug.
Can I use a PAP if I have health insurance?
Generally no, if your insurance covers the specific medication. PAPs are designed for people who are uninsured or whose insurance does not cover the drug, or who have Medicare without Extra Help coverage. If you have commercial insurance that covers the drug but the copay is unaffordable, ask your doctor or pharmacist about copay assistance cards, which are different from PAPs and do not require uninsured status.
How long does it take to get approved for a patient assistance program?
Most PAP approvals take 2 to 6 weeks from the date the manufacturer receives a complete application including the physician certification. Some manufacturers offer expedited review for urgent medical situations. Call the program directly to ask about expedited options if you cannot wait.
Do I need my doctor's help to apply?
Yes. Every PAP requires a licensed physician to certify the prescription as part of the application. The physician section usually takes 10 to 15 minutes to complete. Your doctor's office should be familiar with the process. If they are not, download the form from the manufacturer website and bring it to the office yourself.
Can I apply for multiple PAPs at the same time?
Yes. If you take multiple brand-name medications, you can apply to a separate PAP for each one. Each application is submitted independently to the respective manufacturer.
Are generics covered by patient assistance programs?
No. PAPs cover brand-name drugs. Generic medications are not eligible because they already have low-cost alternatives. For common generics like atorvastatin, lisinopril, or metformin, the most effective approach is to use a discount program like GoodRx, use Cost Plus Drugs at costplusdrugs.com, or ask your pharmacist for the lowest-cost generic option. Prices under $10 per month are common for many generics.
What if I am on Medicare Part D and need help with a covered drug?
If you have Medicare Part D, first apply for Medicare Extra Help (also called Low Income Subsidy or LIS) at ssa.gov/benefits/medicare/prescriptionhelp.html. For 2026, Extra Help income limits are $23,475 for singles and $31,725 for married couples. If you are denied Extra Help and your income is below 150% FPL, contact the manufacturer of your drug directly to ask whether they will consider your PAP application under their Medicare exception policy.
What is the difference between a PAP and a copay card?
A PAP provides the medication free of charge to uninsured or underinsured patients. A copay assistance card (also called a copay coupon or manufacturer coupon) reduces your copay if you already have private insurance. Copay cards cannot be used by Medicare or Medicaid enrollees. PAPs typically cannot be used by patients with adequate private or government drug coverage.
Where is the best place to search for all available PAPs for my medication?
NeedyMeds.org and RxAssist.org are the two most comprehensive free directories. Search by your exact medication name or active ingredient. Both sites list manufacturer PAPs, state pharmaceutical assistance programs, disease-specific foundations, and other assistance options side by side.
