Find Out If You May Be Eligible
This free prescription program is available to individuals who meet certain income requirements, don’t have insurance coverage, are being treated as an outpatient by a United States licensed doctor, and live in the United States or a U.S. Territory.
To find out if you may be eligible, just answer a few simple questions or view our eligibility requirements.
Step 1 of 4
What medicine have you been prescribed?
The information you enter will not be saved or used in any way. This is meant as guidance only.
Step 2 of 4
How many people are in your family?
Step 3 of 4
What is your family’s total income for the year?
Select income level
- Less than $35,640
- $35,641 - $47,520
- $47,521 - $59,400
- $59,401 - $64,080
- $64,081 - $71,280
- $71,281 - $80,100
- $80,101 - $96,120
- More than $96,121
Different medicines have different income eligibility requirements.
Step 4 of 4
Answer the following questions
Based on what you told us,
It appears that you’re not eligible for the program because:
If you wish to speak to someone or have any questions about your eligibility, please call our program at
Do you live in the United States or a United States Territory?
Are you being treated by a United States licensed doctor?
Are you being treated as an outpatient?
Do you have any insurance or Medicare/Medicaid coverage?