MEDASSIST PROGRAM

OVERVIEW

The MedAssist program design focuses on financial assistance to reduce the burden on patients who have high out-of-pocket healthcare costs that they cannot afford. This program is similar to other government support programs like Cal-Fresh and CalWORKs.

Eligible patients who participate in MedAssist will receive up to three (3) grants to off-set high out-of-pocket prescription expenses for their insulin, asthma inhalers, and/or epinephrine auto-injectors.

Grants will be tiered based on three (3) factors:

  1. Household annual gross income
  2. Disease state or medical condition (diabetes, asthma, severe allergies)
  3. Total out-of-pocket healthcare expenses from the previous calendar year (January 2020 – December 2020). Out-of-pocket healthcare expenses include medical and prescription co-payments and insurance premiums.

Once a patient has enrolled and the value of grant(s) they are eligible for has been determined, they will receive monthly disbursements as long as they submit proof of filling a prescription for an insulin or asthma inhaler, or proof of having an unexpired epinephrine auto-injector on hand during that month. Medication adherence remains a key part of the program, as patients are required to provide proof of consistent medication fill, (or for epinephrine, possession of unexpired medication) to continue to receive grant disbursements.

Please note that all application approvals are based on available funding and are on a first-come-first-served basis.

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ELIGIBLITY

  1. Age 18 years or older
  2. Resident of Santa Clara County
  3. Must have valid prescription for asthma inhaler, insulin, or epinephrine auto-injector
  4. Must have household out-of-pocket health care expense in the previous calendar year.
  5. Maximum gross household income cannot exceed the following amounts:

Household Size*

Maximum Annual Gross Household Income Cannot Exceed The Amount Below

1

$ 122,231

2

$165,316

3

$208,400

4

$251,485

5

$294,570

6

337,654

7

$380,739

8

$423,823

*Household size includes yourself, your spouse or domestic partner and dependent children under age twenty-one(21), whether living at home or not.