Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Generic Assistance Program (GAP)

This program provides medication at no cost.

Provided by: NeedyMeds and Rx Outreach

PO Box 219
Gloucester, MA 01931

TEL: 888-203-7687


ALT PHONE: 978-515-7874
Languages Spoken:

English Spanish

 

Patient Assistance Applications

 

Generic Name Medications Covered

 
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage for needed medication
Those with Part D Eligible? Yes, if medication is not covered or those in the donut hole
Income At or below 200% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must reside in the US and be under the direct care of a US physician
   

Application

Obtaining Call or download
Receiving Faxed, emailed, mailed or downloaded
Returning Email, fax or mail
Doctor's Action Complete section
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified in writing
Decision Timeframe 2-3 weeks
   

Medication

Amount/Supply Up to 90 day supply
Sent To Patient's home
Delivery Time 1-3 business days
Refill Process Patient must contact company
Limit One request per patient
Re-application New application yearly
   

Additional Information

When approved, the medication vouchers will be mailed.


Updated January 14, 2019