Medication Assistance Program
A free, eligibility-based, prescription assistance program is available through Blue Ridge Medical Center. The Medication Assistance Program (MAP) was developed to assist qualified patients in securing prescription medication. Federal poverty guidelines are used to determine eligibility. The MAP program is made possible by a grant from the Virginia Health Care Foundation. To apply for MAP, please make sure you have completed the MAP Application entirely. If not, your application will be returned to you and may cause a delay in obtaining assistance.
- Attach copies of proof of income for you and all dependent persons in the household. Attachable documents include:
- Federal Income Tax (form 1099 or 1040EZ) with appropriate schedules (C and/or F) OR Social Security benefit statement, award letter, or bank statement (showing direct deposit)
- Current pay stub for all employers (within the last 2 months).
- Attach a list of current medications with strengths and dosing instructions.
- List your doctor with address and phone number.
- Copy of prescription coverage (card), if applicable.
- Sign and date the application.
