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Welcome to the Application Forms Center
Whether or not you have used BenefitsCheckUpRx™ to find
prescription drug savings programs and other valuable federal and state
programs you may qualify for, you can use ABC's Application Forms Center to
easily access Application Forms and Fact Sheets for over 250 prescription
assistance programs, including state pharmacy programs, patient assistance
programs and Medicare-approved discount drug cards. In addition, you will also
find Application Forms from your State’s Medicaid and Medicare Savings
Programs.
There are four easy ways you can search for Application
Forms:
- by drug (you may select the brand name or generic name);
- by application form category;
- by state; and
- by
application form date.
Most Application Forms can be viewed here, printed
out and filled out by hand. In most cases, you will have to mail them in an
envelope to the address found on the form or the Fact Sheet. A few forms are
fillable online - meaning you can fill them out while on your computer and
print them.
Click here to view the hundreds of
prescription savings options and other valuable federal and state programs the
Application Forms Center has available for you.
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