Immediate Medication Assistance

Immediate Medication Assistance

Cancer drugs can be expensive – even with insurance. But they also can improve your outcome and your quality of life. That’s why it’s important to fill your prescriptions and take them and other non-prescription medications exactly as your doctor prescribed.

Don’t delay or skip your medications due to costs. Learn how you can get quick help with medication costs.

What’s Immediate Assistance?

When you aren’t able to cover your cost to fill a prescription, apply for immediate medication assistance. With this partnership for medication assistance, The APG Foundation makes a pharmacy payment for you. That means you don’t need to pay upfront, submit a receipt, and then wait for reimbursement.

How to Get Rx Help

To apply for immediate assistance, follow these steps:

  1. Complete the immediate medication assistance application below.
  2. Ask your doctor to send your prescription to a participating pharmacy.
  3. Pick up your medication from the pharmacy. The pharmacy sends your bill directly to The APG Foundation.

Participating Pharmacies

Choose from our participating Cedar Rapids pharmacy partners:

Compete the two steps below to apply for Immediate Medication Assistance:

  1. Use the paper form, Immediate Medication Assistance Application, if you need immediate assistance paying for medications as soon as possible. Print and complete the form and take it to one of the two pharmacies partnering with The APG Foundation, and
  2. Complete the application below, following the instructions within the application, OR Complete paper forms, Medication & Protheses Assistance Application and Confirmation of Diagnosis, and mail them to The APG Foundation, P.O. Box 1248, Cedar Rapids, IA 52406-1248 OR scan and email the documents to


    Physician Information:

    Required Supporting Documents

    Please provide documents outlined below.

    You may submit digital copies (PDFs or images) with this form, or you may send print copies to APG Foundation, P.O. Box 1248, Cedar Rapids, IA, 52406-1248

    By submitting your information electronically, you acknowledge that you submitted protected health information (PHI). Please be aware that email communication can be intercepted in transmission or misdirected.

    Consent & Authorization

    By submitting this form:

    • I attest that to the best of my knowledge the information provided is accurate.
    • I affirm that I have no other readily available means to purchase prescribed medications and prostheses.
    • I agree to provide a confirmation of diagnosis form and receipt(s) with information identified above.
    • I agree to provide further information if needed.