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Are You Eligible?

Eligibility requirements vary from program to program. However, here are some general guidelines PASS has established to assist in determining eligibility. Once PASS receives your enrollment form, we can review your information to better determine whether you are likely to qualify for assistance.

• Total annual income of approximately $19,000 or under if single, $26,000 or under if household of 2 or more people (includes all sources of income).
• No prescription coverage from an insurance policy or government assistance program (e.g.: Medicaid, Veteran’s Administration, state assistance, etc…). If there is prescription coverage from an insurance policy, the applicant must have exhausted the coverage limit or the prescription medication is not covered under the policy.
• Individuals in a catastrophic medical situation (e.g., cancer) in which the drug treatments place them in a financial hardship regardless of income.
• You are experiencing financial hardship in obtaining your prescription medications.

If these guidelines generally apply to you, don't wait - complete your enrollment form today! If you are uncertain about your eligibility, contact us at 1-800-727-7479, we'll be glad to talk to you!