Important Program Updates

• Program income eligibility requirements will remain at 300% of the Federal Poverty Level (FPL) for Primary and Specialty products
• Program income eligibility requirements will remain at 500% of FPL for Rare Disease products

• As a program of last resort, the AZ&Me program will continue to require that new and re-enrolling Specialty and Rare Disease Medicare patients who meet program eligibility requirements and are Conditionally Approved pursue other assistance options including independent nonprofit organizations (INOs) grants before completing their enrollment for 2026
• INO grants can help eligible patients with costs such as copays, premiums, deductibles, and out-of-pocket expenses for their medication(s)
• If the patient does not qualify for applicable INO assistance or all available funds are closed, the patient must complete the Specialty & Rare Disease Medicare Enrollment Form as proof of denial or fund closure from three (3) INOs
  • The completed form may be uploaded on the AZ&Me website, faxed to 1-877-239-0867
or opted-in patients may utilize the AZ&Me Digital Assistant to complete and submit the form
  • The form must be received on/after January 1, 2026
  • If submitting proof of fund denials, the patient must attach copies/screenshots from three (3) INOs with the completed form
  • Denial letters/screenshots must be time and date stamped on/after January 1, 2026
    • Must be received within 15 days of time/date stamp
  • If the patient obtains an INO grant that does not cover the full $2,100 Medicare Out-of-Pocket maximum, that INO will count as 1 of 3 required INO denials/fund closures
    • Patients should still pursue these grants as many can be utilized for insurance premiums and other medical expenses
  • If the patient does not have a Part D plan or does not have coverage for the product, they should indicate this on the Specialty & Rare Disease Medicare Enrollment Form
    • Medicare patients who do not have a Part D plan or coverage for the requested product through their Part D plan will not be required to submit proof of three INO fund denials or closures
  • For a list of some independent charitable assistance foundations that may be able to assist, patients can visit:
    • https://fundsupport.reassist.app
    • Click HERE to download a list of Independent Patient Assistance Foundations
• Once the completed Specialty & Rare Disease Medicare Enrollment Form and applicable supporting documentation are received and confirmed, the Conditionally Approved patient’s enrollment will be fully approved, and a Final Approval notification will be sent to the patient and their provider

No, AZ&Me income eligibility requirements will remain the same in 2026

• Annual adjusted gross household income must be at or below 300% of the Federal Poverty Level (FPL) for Primary and Specialty products (no change)
• Annual adjusted gross household income must be at or below 500% of the Federal Poverty Level (FPL) for Rare Disease products (no change)

AZ&Me should always be positioned as a program of last resort. As such, Specialty and Rare Disease Medicare patients should exhaust other avenues of assistance, including independent charitable assistance foundations, prior to completing their 2026 enrollment.