For Patients
For Physicians
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MEDBANK lets you do what you do best: care for patients.  With our help, you and your staff can spend more time with your patients.  Chronic care medications, when taken as prescribed, lower medical costs for everyone and improve the quality of life and health of patients.

How the Program Works

Please click on "Locations" to find the program closest to you.

  • To refer a patient, physician/prescriber must complete and submit a Referral Form to MEDBANK.

    Referral Form (MS Word format)
    View Medbank's Formulary
    View companies that have patient assistance programs
  • Physician/prescriber and patient complete a referral form, including a list of the patient's prescribed medications (Brand Name Only)
  • Patient provides proof of income and insurance information to MEDBANK to verify eligibility.
  • Patient must sign a consent/authorization form.
  • MEDBANK Program representative identifies Patient Assistance Programs for the patient, completes applications and where required obtains written prescriptions from physician - and patient and/or physician signatures.
  • Most pharmaceutical companies will ship a 90-day supply to the physician's office.
  • Patient notifies the MEDBANK Program representative when medications are received and the MEDBANK Program representative repeats applications.

Patient Application Requirements

  • Patient demographic information
  • Social Security number or green card
  • Verification of income (tax return, pay stubs)
  • Statement of benefits (Award) letter from Social Security
  • List of medications (Brand Name medications only)
  • List of assets (home, savings, checking, CD's, IRA's, etc.)

Initially the process can take between 2-4 weeks depending on whether the drugs come from our pharmacy or the drug company. Talk with your physician or health care professional about what to do until your medication arrives.

For additional questions please call us or read the Frequently Asked Questions section.

Company Programs & Medicare Part D

Patient Assistance Program Eligibility Criteria and Medicare Part D


Quick Facts

Over 5,600 providers participate in the Maryland MEDBANK Program.

Last updated:

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