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<form id="medication-eligibility-form" action="#" class="component medication-eligibility-form__form col-12">
  <div class="medication-eligibility-form__form-element-container js-eligibility-form-element-container">
    <input class="medication-eligibility-form__form-input-textbox js-eligibility-form-element js-eligibility-form-age " type="number" placeholder="Age" min="1" max="150">
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Qualification requirements for some assistance programs are age-based. Knowing your age helps us determine resources that you might be eligible for.">
            </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-element-dropdown-container js-eligibility-form-element-container">
    <div class="medication-eligibility-form__form-select-container">
      <button class="medication-eligibility-form__form-select-dropdown js-eligibility-form-element js-select-state-dropdown"> State/Province/Territory </button>
      <ul class="medication-eligibility-form__form-select-options js-select-state-dropdown-options">
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="AL">Alabama</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="AK">Alaska</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="AZ">Arizona</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="AR">Arkansas</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="CA">California</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="CO">Colorado</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="CT">Connecticut</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="DE">Delaware</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="DC">District Of Columbia</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="FL">Florida</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="GA">Georgia</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="HI">Hawaii</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="ID">Idaho</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="IL">Illinois</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="IN">Indiana</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="IA">Iowa</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="KS">Kansas</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="KY">Kentucky</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="LA">Louisiana</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="ME">Maine</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MD">Maryland</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MA">Massachusetts</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MI">Michigan</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MN">Minnesota</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MS">Mississippi</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MO">Missouri</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="MT">Montana</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NE">Nebraska</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NV">Nevada</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NH">New Hampshire</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NJ">New Jersey</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NM">New Mexico</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NY">New York</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="NC">North Carolina</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="ND">North Dakota</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="OH">Ohio</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="OK">Oklahoma</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="OR">Oregon</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="PA">Pennsylvania</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="PR">Puerto Rico</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="RI">Rhode Island</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="SC">South Carolina</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="SD">South Dakota</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="TN">Tennessee</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="TX">Texas</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="UT">Utah</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="VT">Vermont</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="VA">Virginia</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="WA">Washington</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="WV">West Virginia</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="WI">Wisconsin</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-state-select-option" data-value="WY">Wyoming</li>
      </ul>
    </div>
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Qualification requirements for some assistance programs are determined by where you live. Providing the state, province or territory where you live helps us identify additional eligible resources for you.">
            </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-element-container js-eligibility-form-element-container">
    <input class="medication-eligibility-form__form-input-textbox js-eligibility-form-element js-eligibility-form-household-count" type="number" placeholder="Number of people living in the household" min="1" max="14">
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Some assistance programs determine eligibility based on the size of the prescribed patient’s household. Household size is usually calculated based on the number of individuals included on the tax return filed for that household. So the basic formula would be “Tax filer + spouse (if filing jointly) + tax dependents = household size.” For example, two parents who file taxes jointly and claim one of their children as a dependent would be a household size of three.">
            </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-element-container js-eligibility-form-element-container">
    <input class="medication-eligibility-form__form-input-textbox js-eligibility-form-element js-eligibility-form-household-income" type="number" placeholder="Yearly household income" min="1" max="1000000">
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Some assistance programs determine eligibility based on the income level of your family/household. Household income is usually calculated using the total gross income reported on the tax return for your household. So if the prescribed patient is a dependent child, the household income would be the total gross income that child’s parents reported on their latest tax return.">
            </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-element-dropdown-container js-eligibility-form-element-container">
    <div class="medication-eligibility-form__form-select-container">
      <button class="medication-eligibility-form__form-select-dropdown js-eligibility-form-element js-select-residency-status-dropdown"> Residency status </button>
      <ul class="medication-eligibility-form__form-select-options js-select-residency-status-dropdown-options">
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-residency-status-select-option" data-value="1">United States</li>
        <li tabindex="0" class="medication-eligibility-form__form-select-option js-form-residency-status-select-option" data-value="0">Non-U.S. Citizen</li>
      </ul>
    </div>
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Some assistance programs have eligibility requirements based on U.S. citizenship and/or residency. To determine if you’re eligible for any of these assistance resources, we need to know your citizenship status.">
            </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-group-radio-container js-eligibility-form-element-container">
    <div class="medication-eligibility-form__form-group-radio-label">Are you insured?</div>
    <label class="medication-eligibility-form__form-input-radio-label">
      <input class="medication-eligibility-form__form-input-radio js-eligibility-form-element js-eligibility-form-insured" type="radio" id="insured-yes" name="insured" value="Yes" tabindex="0"> Yes </label>
    <label class="medication-eligibility-form__form-input-radio-label">
      <input class="medication-eligibility-form__form-input-radio js-eligibility-form-element js-eligibility-form-insured" type="radio" id="insured-no" name="insured" value="No" tabindex="0"> No </label>
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="We need to need know whether you have health insurance or not because some assistance programs have eligibility requirements based on health insurance coverage.">
                </a>
    </div>
  </div>
  <div class="medication-eligibility-form__form-insurance-type-container js-eligibility-form-element-container js-insurance-type-container">
    <div class="medication-eligibility-form__form-insurance-type-title">What type of insurance coverage do you have?</div>
    <label class="medication-eligibility-form__form-input-checkbox-label">
      <input class="medication-eligibility-form__form-input-checkbox js-eligibility-form-element js-private-insurance-checkbox" type="checkbox" id="" name="checkbox" for=""> Private insurance </label>
    <label class="medication-eligibility-form__form-input-checkbox-label">
      <input class="medication-eligibility-form__form-input-checkbox js-eligibility-form-element js-medicare-checkbox" type="checkbox" id="" name="checkbox" for=""> Medicare </label>
    <label class="medication-eligibility-form__form-input-checkbox-label">
      <input class="medication-eligibility-form__form-input-checkbox js-eligibility-form-element js-medicaid-checkbox" type="checkbox" id="" name="checkbox" for=""> Medicaid </label>
    <label class="medication-eligibility-form__form-input-checkbox-label">
      <input class="medication-eligibility-form__form-input-checkbox js-eligibility-form-element js-va-military-checkbox" type="checkbox" id="" name="checkbox" for=""> VA/Military benefits </label>
  </div>
  <div class="medication-eligibility-form__form-group-radio-container js-eligibility-form-element-container">
    <div class="medication-eligibility-form__form-group-radio-label">Recent natural disasters?</div>
    <label class="medication-eligibility-form__form-input-radio-label">
      <input class="medication-eligibility-form__form-input-radio js-eligibility-form-element js-eligibility-form-recent-disaster" type="radio" id="recent-disaster-yes" name="recent-disaster" value="Yes" tabindex="0"> Yes </label>
    <label class="medication-eligibility-form__form-input-radio-label">
      <input class="medication-eligibility-form__form-input-radio js-eligibility-form-element js-eligibility-form-recent-disaster" type="radio" id="recent-disaster-no" name="recent-disaster" value="No" tabindex="0"> No </label>
    <div class="medication-eligibility-form__form-tooltip-container">
      <div class="medication-eligibility-form__form-divider"></div>
      <a class="medication-eligibility-form__form-tooltip js-form-tooltip" data-toggle="tooltip" title="" tabindex="0" data-original-title="Some resource programs provide medication assistance to individuals who have been negatively impacted by a recent natural disaster. If you have been affected in such a way, we might be able to find additional resources to help you.">
                </a>
    </div>
  </div>
</form>

Text Content

English
 * English
 * español


MEET MAT, THE MEDICINE ASSISTANCE TOOL

PhRMA’s Medicine Assistance Tool (MAT) is a search engine designed to help
patients, caregivers and health care providers learn more about the resources
available through the various biopharmaceutical industry programs. MAT is not
its own patient assistance program, but rather a search engine for many of the
patient assistance resources that the biopharmaceutical industry offers.


‹›

×

Step 1 of 3: Search
 * 
 * 
 * 

Enter medications that you need help accessing:

My medication list:
No medicines added yet.
Is your medication list complete?
Next
Step 2 of 3: Complete form
 * 
 * 
 * 


ENTER YOUR INFORMATION TO SEE WHICH RESOURCES MAY BE AVAILABLE FOR YOU.

Please answer all questions below to see resources that may be available to you
based on the information you provided. Personal information will never be saved
or shared pursuant to our Privacy Policy and Terms of Use.



State/Province/Territory
 * Alabama
 * Alaska
 * Arizona
 * Arkansas
 * California
 * Colorado
 * Connecticut
 * Delaware
 * District Of Columbia
 * Florida
 * Georgia
 * Hawaii
 * Idaho
 * Illinois
 * Indiana
 * Iowa
 * Kansas
 * Kentucky
 * Louisiana
 * Maine
 * Maryland
 * Massachusetts
 * Michigan
 * Minnesota
 * Mississippi
 * Missouri
 * Montana
 * Nebraska
 * Nevada
 * New Hampshire
 * New Jersey
 * New Mexico
 * New York
 * North Carolina
 * North Dakota
 * Ohio
 * Oklahoma
 * Oregon
 * Pennsylvania
 * Puerto Rico
 * Rhode Island
 * South Carolina
 * South Dakota
 * Tennessee
 * Texas
 * Utah
 * Vermont
 * Virginia
 * Washington
 * West Virginia
 * Wisconsin
 * Wyoming




Residency status
 * United States
 * Non-U.S. Citizen


Are you insured?
Yes No

What type of insurance coverage do you have?
Private insurance Medicare Medicaid VA/Military benefits
Recent natural disasters?
Yes No

Show Resources

 * WHAT IS MEDICINE ASSISTANCE TOOL (MAT)?
   
   PhRMA’s Medicine Assistance Tool (MAT) is a web platform designed to help
   patients, caregivers and health care providers learn more about the resources
   available through the various biopharmaceutical industry programs offered to
   those who need financial support due to their lack of insurance or inadequate
   prescription medicine coverage. MAT is not its own patient assistance
   program, but rather a search engine for many of the support programs and
   resources that the biopharmaceutical industry has been offering for decades.

 * WHAT ROLE DO HEALTH CARE PROVIDERS PLAY IN MAT?
   
   Health care providers play a crucial role in spreading the word that patients
   in need may be eligible for various forms of assistance in obtaining their
   medications, including some free or nearly free options. Physicians, nurses
   and other health care providers can also go to www.mat.org to get information
   on available patient assistance programs, co-pay support programs and other
   helpful resources for the patients under their care. Additionally, many of
   the financial assistance programs require physicians to sign and fill out
   portions of program enrollment forms, including adding patient prescription
   information. Some programs also require the physician to mail or fax the
   enrollment form on behalf of the patient.

 * DO I MAIL MY COMPLETED ENROLLMENT FORMS TO MAT?
   
   No. MAT helps you find programs and resources you may be eligible for but
   does not process the enrollment applications for those programs. A program’s
   enrollment application typically provides directions on where it should be
   emailed, faxed or mailed.

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PATIENT RESOURCES

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EDUCATION

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