Please Call: 877-386-0206 ext 1

For the prescription assistance program, please call us and one of our consultants will help you choose the right program.

Thank you and we look forward to helping you!

Eligibility Guidelines

Prescription Assistance Program & Foundation Grant Eligibility
In order to qualify for a Prescription Assistance Program (PAP) or Foundation Grant, you must meet certain requirements:

  • Your income is less than $80,000 annually (PAP)
  • Your income is less than $105,570 annually (Grant)
  • You are a citizen of the United States
  • You do NOT have private or employer insurance

*Simplefill keeps all of your information confidential and will not share with any 3rd party solicitors.

Patient Information





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Medication Information