Patient Assistance

Financial assistance for the treatment you’ve been prescribed.

Triple Aim Health Foundation provides charitable financial assistance to eligible patients who need help with out-of-pocket costs for certain provider-administered prescription medications.

Our current Autoimmune & Inflammatory Disease Fund serves eligible Medicare Part D patients and provides assistance of up to $2,100 per calendar year.

Eligibility

To be considered for assistance, patients must:

Triple Aim Health Foundation independently determines eligibility based on the information and documentation submitted, current program requirements, and available funding.

  • Be enrolled in Medicare Part D
  • Have a qualifying diagnosis and prescribed provider-administered medication
  • Have household income at or below 300% of the applicable Federal Poverty Level
  • Live in the United States or a U.S. territory and receive treatment there
  • Meet the Fund’s current program requirements

Applying for assistance

Applications may be submitted by the patient or completed on the patient’s behalf by an appropriately authorized representative, such as a family member, caregiver, healthcare provider, clinic representative, or pharmacy representative.

The application will request the information and supporting documentation needed to determine eligibility.

After you apply

Triple Aim reviews the application and any supporting documentation needed to confirm eligibility.

If additional information is required, we may contact the patient, authorized representative, or healthcare provider.

Approved applicants will receive their award amount and instructions for accessing assistance.

Using your award

Eligible patients may receive up to $2,100 per calendar year toward qualifying out-of-pocket prescription costs.

Assistance is not paid directly to the patient as cash.

An approved award must be used toward an eligible prescription claim within 60 days of the award date. After the first eligible use, any remaining balance may be available through December 31 of the same calendar year, subject to program terms and available funding.

Triple Aim generally provides one approval per patient per program year.

Independent assistance. Independent treatment decisions.

Triple Aim provides financial assistance and does not prescribe medications or determine which treatment is medically appropriate.

Treatment decisions remain between patients and their healthcare providers. Eligibility for assistance is determined independently and is not conditioned on the use of a particular provider, pharmacy, manufacturer, or referral source.

Questions?

For questions about eligibility, an application, or an existing award:

applications@tripleaimfoundation.org