- You must live in Maryland or see a physician whose
office is in Maryland
- You do not have prescription coverage as part of your
- You meet the financial guidelines set by the drug
- You are not enrolled in entitlement programs such as
Medicaid or the Maryland Adult Primary Care Program
the Medbank office toll-free 1 877 435-7755 (Baltimore local
410 821-9262) and ask for a new patient referral
Complete and sign the two-page
Make copies of proof of income from all
Take your completed questionnaire,
proof of income and physicians referral form to your
Ask them to complete the physician
referral form and fax or mail it to our office with your
application and proof of income
The Patient Representatives at Medbank will process your
application. Medbank has a pharmacy that stocks about
100 medications. If the medication you need is stocked
in our pharmacy, we will send it to your doctor's office for
you to pick up. If we do not stock the medication in
our pharmacy, we will apply directly to the drug companies'
Patient Assistance Programs for the medicine your doctor has
prescribed for you. In most cases, you will receive a
90-day supply of each medicine you are taking.
When you pick up a medication from your doctor's office, call
Medbank and let us know the name of the medicine you have picked up.
We will track when it is time to renew your medication. When
your first prescription is almost gone, another 90-day supply will
be waiting for you at your doctor's office. Medications
continue to come every 90 days and you are re-qualified financially
once a year.
What if my Doctor prescribes a new
If at any time you stop taking a medeication or your doctor
prescribes a new medicine, call the Medbank office and they will
process the change.
Click to find the Maryland Medbank Office
list of medications that have Patient Assistance Programs
the new Patient Referral Packet