Application process chart

If you meet all five (5) eligibility criteria and funding is available, your application will be approved pending supplemental documents.

Please check your e-mail for a link to complete the required Supplemental Documents through DocuSign.

Alternatively, if you applied by paper application, please submit the Supplemental Documents by mail, fax, or drop-off at any SCVMC Outpatient Pharmacy. The Supplemental Documents are available on the Forms page of the MedAssist website.

Failure to submit the supplemental documents within thirty (30) calendar days will result in your application being withdrawn.

Required Supplemental Documents Checklist*:

  1. Automated Clearing House (ACH) Registration
  2. W-9

*You will be contacted using the information you provided if any additional information or documents are required.

Please login to the portal here to check the details of your application approval and grant award or contact the MedAssist office.

If you applied by mail, fax, or drop-off at a SCVMC Outpatient Pharmacy, you will be notified of any changes to your application status by letter and/or phone.

Grant Payments

Upon approval of your application, you will be awarded a grant for each disease state or medical condition that you provided a valid prescription for. You may be eligible to receive up to three (3) grants.

Prescription Grant Type (Disease State or Medical Condition)
Diabetes Medication Diabetes
Asthma Inhaler Asthma
Epinephrine Auto-injector Severe Allergies


Your first grant payment will be issued within ten (10) business days of your application approval date.


To receive subsequent grant payments, you will need to sign a self-attestation form to confirm that you are regularly taking your medications. 

The default method of payment is direct deposit however you have the option to receive grant payments via paper check. Please select “check” for your payment method on the ACH Registration form to opt-out of direct deposit.  

You can always check the details of your grant by logging into the portal here or by contacting the MedAssist office.