A prescription assistance program, known as the Medication Assistance Program (MAP), is provided by Blue Ridge Medical Center. This program, designed for eligible individuals, aims to help qualified patients obtain necessary prescription medications. Eligibility is determined based on the federal poverty guidelines. The MAP initiative is made achievable through a generous grant from the Virginia Health Care Foundation. To initiate the application process for the Medication Assistance Program (MAP), it is essential to ensure completion of the following: Fill out the entire MAP Application. Incomplete applications will be returned, potentially causing delays in receiving assistance.

Include copies of proof of income for both yourself and all dependents in the household. Acceptable documents for attachment are:

• Federal Income Tax (form 1099 or 1040EZ) along with the relevant schedules (C and/or F), OR Social Security benefit statement, award letter, or bank statement (reflecting direct deposit)
• Current pay stubs for all employers within the past 2 months

Additionally:

• Attach a detailed list of current medications, specifying strengths, and dosing instructions
• Provide the contact details of your primary doctor, including their address and phone number
• If applicable, include a copy of your prescription coverage card
• Sign and date the application before submission

Medication Assistance Program Application