Apply Now!
This simple online application will help you determine if you’re qualified for prescription assistance, and it will help you start the application process. After providing information about yourself, you’ll be asked to enter your current medications. All information you provide is confidential.
The entire application process consists of three steps:
Step 1 Apply at RxYes.com.
Step 2 Receive your completed application in the mail.
Step 3 Return your signed application to RxYes! with any required documents.
RxYes! eliminates confusion by providing the following services:
- Step-by step assistance
- Mailed Application Kit
(includes your completed personalized PAP forms from each pharmaceutical company) - Highlighted Form Signature Fields
- Mailed Application Review
(We make sure your information is accurate and forms are properly signed.) - Monthly Subscription Service
(We're here to answer your questions and help you whenever you need us.) - Medication Re-orders
(We help to keep you enrolled in each PAP on a month-to-month basis.) - Application Renewals & Annual Recertification
(We mail your forms for you.) - Low Application Fee
