Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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The lowdown...

  • Medical assistance is available when supported by a doctor’s determination
  • A request for medical assistance can get help for illness or other medical conditions
  • One must provide some basic information to support a request for medical assistance
  • Medical assistance varies by location and current availability


Medical expenses can exhaust personal resources and exceed insurance coverage. When patients have greater debt than they can pay or must use medications that they cannot afford, the letter of request for medical assistance is an important step towards finding relief.

Comparison shopping is an ideal method for finding insurance that provides the best coverage for health services and prescription drugs. One can use comparison shopping to emphasize features of greatest importance such as the price of drugs and copays.

Enter your zip code above to use our comparison tool for free today.

The Affordable Care Act

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Before the enactment of the Obamacare legislation, the nation’s health system was broken, and it was under a burden that would have broken it further.

The cause was evident and simple, the unpaid medical bills of patients with and without insurance burdened local health systems and caused a cascading effect of failures.

Joined with a trend among Republican governors and legislatures to cut taxes and not increase spending for health services, many states and counties experienced an epidemic of hospital and clinic closings.

Even after the Affordable Care Act was set in place, many would still admit the health system of this nation is still broken.

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Everyone Needs Medical Care

The simple truth is that each person will encumber a lot of medical expenses in life and the last illness.

The public policy requires that we treat and give every person the best chance at survival from the following:

  • illness
  • accident
  • disease

The insurance industry preferred to avoid losses and costly cases and discriminated against people who were or might become expensive expenditures. Those discriminated against included women who could have children and children born with preexisting conditions.

Basic Information for All Requests

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The letter must show a type of medical necessity in which one of the following three statements is true.

  1. First, treatment or medication is needed to prevent illness or condition.
  2. Second, the patient needs the medication or treatment to maintain present state of independence.
  3. Third, the applicant needs the medications or medical treatment to prevent worsening of an illness or vital health conditions.

In addition to one of the three conditions of necessity, one must include the below-listed items as standard information for all requests.

  • Name, address, email, and phone number
  • Medical records or a summary that supports the need
  • Fill out any required forms on the company’s or organization’s website
  • Offer to add any additional information the receiver might need

Costs of Medications

When faced with medication costs that exceed one’s ability to pay, it is important to act quickly.

Many manufacturers and medical care providers offer some form of assistance to help with the often alarming costs of medications.

The first step should be to ascertain whether there may be a lower costs alternative drug to that which one cannot afford.

Name brands cost more than generics, and under some plans, a particular drug may cost less than market prices. New drugs get approvals from the FDA, and some new drugs are more effective than older formulas and costs less.

One must remember that drugs are a commodity and the price may depend on nothing so much as the profits that the owner wishes to get.

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Assistance for Medications

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Heart patients, transplant recipients, cancer patients and many other categories of persons need regular doses of high-cost medications.

Immune suppressants, chemical blockers, and specialized compounds can cost thousands per month. For example, organ transplants now include hearts, lungs, and intestines as well as the older types for end-stage kidney and liver conditions.

Recipients of transplanted organs must maintain immune suppression on a daily basis for their lifetimes.

Without insurance, the costs can easily exceed $5,000 per month. With insurance, the costs for patients in these categories can easily exceed $1,000 per month for medications alone.

Elements of the Request for Medication Assistance

Medical emergencies can arise at any time for every person. That was the premise of the Affordable Care Act, and it requires that every eligible person get and keep qualified health insurance.

The elements of need include past medical treatment, future medical care, medications, and the estimated costs of all medications and medical care.

One should indicate any levels of public assistance that the patient has received as these indicate evidence of need based on income and other financial means.

Ongoing Medication Treatment

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An attending medical doctor must prescribe the present and future needs for medical treatment to support this type of request for medication assistance.

One should indicate efforts made to find resolution such as alternative drugs and generics with lower costs. The below-listed items should be part of the request for medical assistance for prescription medications.

  • A doctor’s statement treatment is medically necessary
  • Budget statement showing income and expenses
  • Copies of recent bank statements
  • Copies of medical bills that show the costs of treatment

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Request for Assistance with Medical Bills

For ongoing treatment, the letter should focus on the need for treatment that continues into the future. The nature of medical treatment has changed so that thousands of patients get outpatient treatment by medications and clinical follow-up.

These include cases such as cancer recovered patients and transplant recipients that require medicines and clinical treatment such as tests, x-rays, and blood labs.

The present medical bills are part of the problem, but the ability to pay must also address the ongoing need for care and the expenses that come with it.

Obamacare policies do not protect subscribers against bills that come from using out-of-network providers.

Write in Your Own Words

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A Google search will turn up many downloadable forms, examples, and templates for letters of request for medical assistance.

One should feel free to use them. However, there is another view which seems compelling.

Writing in one’s words to express the situation and the need is a more personal piece of evidence and a more persuasive argument in support of a positive decision.

The basic idea is that there is a unique individual in danger of losing needed medical care or prescription medicine treatment.

Their words carry more weight than the form letters can do when it comes to showing the human situation and the compelling need.

Comparison shopping is an excellent tool for maximizing financial resources when selecting insurance for medical care and prescription drugs. Enter your zip code below to begin comparing.