Patient Services

The Assistance Fund offers financial assistance programs to children and adults diagnosed with critical or chronic illnesses.

Copay Assistance Programs: Provide eligible underinsured individuals with financial assistance to cover all or part of the individuals’ out-of-pocket cost for the supported medications. These programs give individuals the ability to afford their medications. Copay Assistance Eligibility Criteria

Financial Assistance Programs: Provide financial assistance for medication copays, health insurance premiums, and basic healthcare needs to children and adults. Financial Assistance Eligibility Criteria

Health Insurance Premium Assistance Programs: Assist those who have health insurance but need help paying for their out-of-pocket premiums for private, independent, COBRA or government health insurance coverage plans. Health Insurance Premium Assistance Eligibility Criteria


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Ankylosing Spondylitis Copay AssistanceLong-term type of arthritis affecting bones and joints at the base of the spine

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Multiple Sclerosis Copay AssistanceA chronic degenerative disorder that affects nerves in the brain and spinal cord

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Clostridium Difficile Associated Diarrhea Copay AssistanceReferred to as c. difficile or C. diff., it is a bacteria that causes gastrointestinal infections resulting in acute diarrhea

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Multiple Sclerosis Health Insurance Premium AssistanceA chronic degenerative disorder that affects nerves in the brain and spinal cord

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Cystic Fibrosis Copay AssistanceDigestive & respiratory tract illness where thick secretions clog airways to the lungs

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Non-small Cell Lung Cancer Copay AssistanceLung cancer that grows and spreads more slowly than small cell lung cancer

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Digestive Mobility & Malabsorption Disorders Financial AssistanceDigestive Disease or Disorder causing intestinal mobility failure/malabsorption.
This includes:
• Short Bowel Syndrome
• Short Gut Syndrome

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Pancreatic Neuroendocrine Tumors Copay AssistancePancreatic neuroendocrine tumors are tumors that form in the islet cells which are the hormone-making cells of the pancreas.

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Hereditary Angioedema Financial AssistanceA rare genetic disease causing severe swelling in the hands, feet, face, throat and intestines.

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Psoriasis Copay AssistanceDisease of the immune system affecting the skin; elbows, knees, scalp and lower back

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Idiopathic Parkinson's Copay AssistanceA degenerative disorder of the central nervous system affecting movement and cognition

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Psoriatic Arthritis Copay AssistanceArthritic inflammation that occurs in a percentage of patients who have a skin rash

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Juvenile Rheumatoid Arthritis Copay AssistanceType of arthritis that happens in children age 16 or younger

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Rheumatoid Arthritis Copay AssistanceChronic autoimmune disease causing inflammation (swelling and pain) of the joints

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Melanoma Copay AssistanceThe most serious type of skin cancer that develops in cells that gives your skin its color. Melanoma is less common than other skin cancers, however, more dangerous if not found early.

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Systemic Lupus Erythematosus Copay AssistanceAutoimmune disease where the immune system attacks normal, healthy tissue

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Other Ways to Apply

The easiest and fastest way to apply or reenroll is to use AssistFund eEnroll. Additionally, you can print and mail the form by clicking here.