Most pharmaceutical assistance program directories either name one resource and move on, or dump a long undifferentiated list without saying who each one is actually for. Neither is useful when you're standing at a pharmacy counter. This guide sorts every real category of prescription help into six groups, shows exactly who qualifies for each, and ends with a simple decision tree so you can go straight to the program that actually applies to your situation instead of applying to five things you don't qualify for.
1. The 6 Categories of Prescription Help
| Category | Best for | Income test? |
|---|---|---|
| Government programs | Medicare and Medicaid beneficiaries | Yes, for most |
| Manufacturer PAPs | Uninsured patients on a specific brand-name drug | Yes |
| Nonprofit copay foundations | Insured patients with high copays on specific conditions | Yes |
| Nonprofit low-cost pharmacies | Anyone needing common maintenance medications cheaply | No |
| Community health centers | Local, sliding-scale care and medication access | Sliding scale |
| Free discount cards | Anyone, any income, any insurance status | No |
Prescription Assistance Programs Income Limits 2026
Every major program uses a different income threshold. Here's the exact dollar amount for a one-person household in the 48 contiguous states:
| Program | Income Limit | Best For |
|---|---|---|
| Medicare Extra Help (LIS) | $23,940 | Medicare beneficiaries with limited income |
| Ozempic PAP (Novo Nordisk) | ~$31,920 (200% FPL) | Uninsured Ozempic patients |
| Lilly Cares Group 1 (Trulicity, Emgality) | ~$47,880 (300% FPL) | Uninsured patients on specific Lilly drugs |
| Pfizer RxPathways | ~$47,880 (300% FPL) | Uninsured patients on Pfizer medications |
| BMSPAF (Eliquis) | ~$45,180 | Uninsured patients on BMS drugs |
| Lilly Cares Group 2 (Humalog, Basaglar) | ~$63,840 (400% FPL) | Uninsured patients on Lilly insulin |
| Novo Nordisk PAP (general) | ~$63,840 (400% FPL) | Uninsured patients on Novo diabetes meds |
| BI Cares (Jardiance) | ~$63,840 (400% FPL) | Uninsured patients on Boehringer meds |
| Lilly Cares Groups 3 & 4 (Taltz, Verzenio) | ~$79,800 (500% FPL) | Uninsured patients on specialty Lilly meds |
| Rx Outreach | No limit | Anyone needing low-cost generics |
| GoodRx / Inside Rx / SingleCare | No limit | Anyone, any income, any insurance |
For each additional household member, add roughly $11,000–$16,000 depending on the program's FPL multiplier. Alaska and Hawaii limits are higher. Call the specific program or see our complete PAP income limits guide for full household-size tables.
2. Government Programs
| Program | Who it's for | 2026 Income Limit | What you pay |
|---|---|---|---|
| Medicare Extra Help (Part D LIS) | Medicare beneficiaries with limited income | ≤$23,940 single / ≤$32,460 married Resources: ≤$18,090 / ≤$36,100 | $0 premium, $0 deductible, ≤$5.10 generic / ≤$12.65 brand |
| Medicare Prescription Payment Plan (MPPP) | All Medicare Part D enrollees | No income limit | Spread OOP costs into fixed monthly payments |
| Medicaid | Low-income individuals/families | Varies by state | $0–$3 per prescription (varies by state) |
| State Pharmaceutical Assistance Programs (SPAPs) | State residents, often seniors | Varies by state | Varies significantly |
| LINET | Newly eligible low-income Medicare enrollees with no drug coverage | Extra Help or Medicaid eligible | Temporary bridge coverage (up to 2 months) |
| VA / TRICARE | Veterans and military beneficiaries | N/A | Low or no cost by priority group |
🆕 New in 2026: Medicare Prescription Payment Plan (MPPP)
Starting January 1, 2026, all Medicare Part D enrollees can opt into the Medicare Prescription Payment Plan to spread out-of-pocket drug costs into fixed monthly payments instead of paying full copays at the pharmacy. This is not a discount program — it doesn't reduce your total annual cost (still capped at $2,100), but it smooths cash flow. You must opt in before picking up your prescription. Contact your Part D plan or call 1-800-MEDICARE to enroll.
Worked example: A Medicare beneficiary earning $22,000 a year qualifies for Extra Help. Instead of paying a Part D deductible and standard coinsurance, they pay no more than $5.10 for a generic or $12.65 for a brand-name drug per fill, and $0 once their total drug costs for the year reach $2,100 — an average value SSA estimates at around $6,200 per year.
3. Manufacturer Patient Assistance Programs
These are drug-specific programs run directly by pharmaceutical companies, providing free medication to uninsured patients who meet income limits — typically 200-400% of the federal poverty level, varying by manufacturer and even by drug. For example, Ozempic's PAP has a 200% FPL limit, while Novo Nordisk's general PAP covers multiple medications at up to 400% FPL. Lilly Cares covers Humalog, Basaglar, and Trulicity (by group), and Mounjaro has separate savings programs and is not part of Lilly Cares. For a full breakdown of how these work and how to apply, see our complete guide to patient assistance programs.
🆕 Pfizer RxPathways 2026 Changes: Pfizer updated its PAP rules this year. The biggest changes: (1) Medicare Part D patients must now enroll in the Medicare Prescription Payment Plan (MPPP) before applying, (2) all patients must apply to alternate funding resources first and provide denial documentation, (3) income limit is 300% FPL (~$47,850 for one person), and (4) prior authorization must be obtained before applying. Read the full details at pfizerrxpathways.com.
4. Nonprofit Copay Foundations
Unlike manufacturer PAPs, nonprofit copay foundations exist specifically to help patients who already have insurance but can't afford the copay or coinsurance on an expensive medication.
| Organization | What changed in 2026 |
|---|---|
| Patient Advocate Foundation | Merged with the PAN Foundation in March 2026, combining copay assistance and case-management resources under one organization |
| PAN Foundation | Now operating as part of Patient Advocate Foundation; its site remains active during the transition |
| HealthWell Foundation | Continues operating independently, covering copay and premium assistance across many disease funds |
Disease funds open and close based on available money. Nonprofit copay foundations run separate funds for specific conditions, and a fund can be fully allocated for the year and close to new applicants. Check current fund status directly on the organization's site before assuming a specific condition's assistance is open.
5. Nonprofit Low-Cost Pharmacies
A separate category from charity programs: nonprofit mail-order pharmacies sell common maintenance medications at flat, low prices to anyone. Rx Outreach is the best-known example — and as of 2026, they have eliminated all income eligibility requirements.
| Feature | Detail |
|---|---|
| Income requirement | None — open to everyone as of 2026 |
| Medications available | 400+ generic and some brand-name drugs |
| Typical pricing | ~$8–$20 for 30-day supply; ~$10–$45 for 90-day supply |
| Shipping | Free FedEx home delivery |
| Phone | 1-800-769-3880 |
| Website | rxoutreach.org |
Why this matters: Before 2026, Rx Outreach required income below ~$32,490 (single). Now anyone can order — making it one of the best fallback options for generics, even if you have insurance (many patients find Rx Outreach prices lower than their copay).
6. Community Health Centers
Federally qualified health centers (FQHCs) offer sliding-scale pricing on visits and, at many locations, on medications dispensed on-site, based on your income regardless of insurance status. These are physical, local resources rather than online programs — searching findahealthcenter.hrsa.gov or "federally qualified health center near me" is the most direct way to find one serving your area.
7. Free Discount Cards
The only category with no income test, no insurance requirement, and no application at all. GoodRx, Inside Rx, and SingleCare all fall here — free to use, accepted at most major pharmacies, and useful as a fallback when you don't qualify for anything more generous. See our Inside Rx review and Inside Rx vs. SingleCare comparison for how these specifically compare.
8. All 12 Programs, Side-by-Side
| # | Program | Category |
|---|---|---|
| 1 | Medicare Extra Help (Part D LIS) | Government |
| 2 | Medicaid prescription coverage | Government |
| 3 | State Pharmaceutical Assistance Programs | Government |
| 4 | LINET bridge coverage | Government |
| 5 | VA / TRICARE pharmacy benefit | Government |
| 6 | Manufacturer PAPs (e.g., NovoCare, Lilly Cares, Pfizer RxPathways) | Manufacturer |
| 7 | Patient Advocate Foundation (incl. PAN Foundation) | Nonprofit copay |
| 8 | HealthWell Foundation | Nonprofit copay |
| 9 | Rx Outreach | Nonprofit pharmacy |
| 10 | Federally qualified health centers | Community |
| 11 | GoodRx / Inside Rx / SingleCare | Discount card |
| 12 | NeedyMeds / RxAssist (directories to find more) | Directory |
Prescription Assistance by Medication
If you're looking for help with a specific drug, these guides break down the exact program, income limits, and application steps:
- Ozempic Patient Assistance Program — 200% FPL limit (~$31,920), Medicare excluded as of 2026
- Novo Nordisk PAP — Covers Wegovy, NovoLog, Tresiba, Victoza (400% FPL, ~$63,840)
- Humalog Patient Assistance Program — Lilly Cares Group 2, 400% FPL (~$63,840)
- Lilly Cares PAP — Basaglar, Humalog, Trulicity, Taltz, Verzenio (by group). Mounjaro not included.
- Mounjaro Patient Assistance Program — Savings card ($25) and LillyDirect, not Lilly Cares
- Eliquis Patient Assistance Program — Pfizer RxPathways / BMSPAF
- Jardiance Patient Assistance Program — Boehringer Ingelheim Cares (400% FPL)
- Farxiga Patient Assistance Program — AstraZeneca
Other Cost-Saving Strategies
For more drug delivery and home shipping options, see our Ozempic mail order guide.
9. Decision Tree: Which Category Fits You?
If nothing above applies, GoodRx, Inside Rx, or SingleCare require no application and can still meaningfully cut your cash price.
10. Step-by-Step: Building Your Own Stack
List every medication you take
Separate them into brand-name (no generic) versus generic, since the right category of help differs sharply between the two.
Check government eligibility first
If you're on Medicare or Medicaid, confirm whether Extra Help or your state's SPAP applies before looking anywhere else.
Check manufacturer programs for each brand-name drug
Search each brand name plus "patient assistance program" individually, since eligibility and income limits differ drug by drug.
Check nonprofit copay funds for your condition
Search Patient Advocate Foundation and HealthWell Foundation by your diagnosis to see if an open fund exists.
Fall back to a discount card for everything else
For remaining generics or drugs with no applicable program, compare GoodRx, Inside Rx, and SingleCare pricing at your pharmacy.
11. Can You Combine These Programs?
Generally, no — not on the same fill. Manufacturer PAPs and copay cards require the pharmacy to process the fill in a specific way that doesn't allow layering a second program on top. What you can do is use a different program for each different medication: a PAP for one brand-name drug, Extra Help for your Medicare-covered generics, and a discount card for anything left over. Think of it as building a personalized combination across your medication list, not stacking multiple discounts onto a single prescription.