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MedAssist staff will review your complete application and assign a grant award amount. Your grant award amount will be equal to your stated expenditure amount, up to a maximum of $200 per month

You are not required to regularly submit proof of medication purchase or refills. However, you must attest to the accuracy of the prescription expenses listed on your MedAssist application. You must also keep any documentation of expenses, as the MedAssist program may request it for auditing purposes. False information provided on the MedAssist application could lead to revocation of the grant at any time and furthermore may constitute fraud for which the Patient or their legal representative may be legally liable. 

Please keep any documentation showing proof of purchase of your qualifying medications for at least one year, as the MedAssist program may request it for auditing purposes. 

Receipt of a MedAssist grant may be considered income to you and may impact your eligibility for public benefits programs, such as CalFresh or CalWORKS. You are encouraged to consult with tax professionals to understand how receiving a MedAssist grant may affect your taxes.

You will not qualify for the MedAssist program if you have prescription drug coverage or other cost support from a federal health care program or a state health care program.[1] This includes, but is not limited to, the following:

  • Medi-Cal (including Managed Care Medi-Cal, such as Santa Clara Family Health Plan and Blue Cross/Blue Sheild, as well as Medi-Cal Fee For Service)
  • MediCare (including Medicare Part D and Medicare Advantage Prescription Drug Plans)
  • TRICARE
  • VA Health Administration 
  • Indian Health Service
  • Children’s Health Insurance Program (CHIP)

[1] A “Federal Health Care Program” is any plan or program that provides health benefits—whether directly, through insurance, or otherwise—which is funded , in whole or in part, by the United States Government (with the exception of the Federal Employees Health Benefits Program).  A State health care program is (1) A State plan approved under Title XIX of the Act (Medicaid), (2) Any program receiving funds under Title V of the Act or from an allotment to a State under such title (Maternal and Child Health Services Block Grant program), (3) Any program receiving funds under subtitle A of Title XX of the Act or from any allotment to a State under such subtitle (Block Grants to States for Social Services), or (4) A State child health plan approved under Title XXI (Children's Health Insurance Program)

If your information has changed – you will need to contact the MedAssist Team. You must notify us if any of the following information has changed:

Personal Information

  • New home address
  • New phone number
  • New e-mail address
  • New contact information

Household

  • Had another child or adopted a child
  • Death in the family
  • Got married
  • Getting divorced
  • Legally separated
  • Have a registered domestic partner

Job Status

 

  • Became unemployed
  • Salary changed
  • Got an extra job
  • Spouse's employment or salary changed

Income

  • Income changes

Health Insurance

  • Health insurance changes

Prescription Expenses

  • Changes to out-of-pocket expenditure for qualifying prescriptions

 

 

Yes, please see details by visiting the “Appeals” webpage: Appeals process | Health System | County of Santa Clara

Yes, you will need to create a new account to submit an application for MedAssist through the online portal. All you need is a valid email address to create your account.

You may continue to receive benefit from the MedAssist program while you meet the eligibility criteria and funding is available for the program year.

Yes, health insurance is not a program eligibility requirement.

After your application is approved, you will be given instruction on how to provide the banking information.

  • Insulin glulisine (Apidra®)
  • Insulin aspart (Novolog®)
  • Insulin lispro (Humalog®)
  • Regular insulin (Novolin R, Humulin R)
  • NPH insulin (Novolin N, Humulin N)
  • Insulin detemir (Levemir®)
  • Insulin glargine U-100 (Lantus®, Basaglar®)
  • Insulin glargine U-300 (Toujeo®)
  • Insulin degludec U-100/U-200 (Tresiba®)
  • Humalog® mix 75/25
  • Humalog® mix 50/50
  • Novolog® mix 70/30
  • Metformin (Glucophage)
  • Glimepiride(Amaryl)
  • Glipizide (Glucotrol)
  • Glyburide (Diabeta)
  • Pioglitazone (Actos)
  • Linagliptin (Trajenta)
  • Sitagliptin (Januvia)
  • Dapagliflozin (Farxiga)
  • Empagliflozin (Jardiance)
  • Dulaglutide (Trulicity)
  • Semaglutide (Ozempic, Rybelsus)
  • Liraglutide (Victoza)

Asthma inhalers include but are not limited to the following list:

  • Albuterol (ProAir®, Ventolin®)
  • Levalbuterol (Xopenex®)
  • Fluticasone (Flovent®)
  • Budesonide (Pulmicort®)
  • Mometasone (Asmanex®)
  • Beclomethasone (QVAR®)
  • Fluticasone and salmeterol (Advair Diskus®)
  • Budesonide and formoterol (Symbicort®)
  • Mometasone and formoterol (Dulera®)
  • Fluticasone and vilanterol (Breo Ellipta®)
  • Salmeterol (Serevent Diskus®)

  • EpiPen® and EpiPen Jr®
  • SYMJEPI® pre-filled epinephrine syringe
  • Generic epinephrine auto-injector

No, your position on the waitlist is determined by the date and time your application was complete. Applications are approved from the waitlist on a first-come-first-served basis as funding becomes available.

Yes. The information you provide will be kept confidential and will be used and disclosed only for program purposes and as described in the County of Santa Clara Health System's Notice of Privacy Practices. NOTICE OF PRIVACY PRACTICES  

Up to three (3) individuals in one household can receive a grant of up to $200 per month from the MedAssist program. 

We're here to help you every step of the way!

Reach out to us
Please call (408) 970-2001.
We are open Monday - Friday,
9:00am - 5:00pm.

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Start your application

Are you ready to start your application? Visit our portal page to begin your application today! It includes some easy to follow questions and the opportunity to submit your documents.

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Approval process

Curious about how the approval process works for MedAssist? Read on for more information about what to expect.

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Forms

We have all the necessary forms ready for you to print. Visit our forms page for everything you need.

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Contact us

Don't hesitate to visit our contact us page and reach out to our team for assistance.