Medication Assistance Program

Are you having difficulty paying for medications?

Community Health Network has a medication assistance program for anyone receiving services in our network. Medication costs are often cited as the reason some patients are unable to adhere to their medication regimens. Medication non-adherence can result in poor health outcomes and increased healthcare expenses.

We can help!

Community's Medication Assistance Coordinators identify how patients may be able to obtain medications at a lower cost:

  • The Medication Assistance Coordinator will determine if the patient qualifies to receive free brand name medications from pharmaceutical companies. If so, the coordinator works with both the patient and healthcare provider to complete the application process optimally.
  • Patients may also be referred to low-cost medication programs or be given drug coupons that allow them to obtain their prescriptions for a discount.
  • The Medication Assistance Coordinator may also suggest a change to the medication regimen, such as switching to a generic medication or switching to a brand name medication that has a patient assistance program for which the patient qualifies.

Apply for Assistance

Contact our Medication Assistance Coordinators today! To begin the process, find the patient's location of care below to contact the coordinator and/or download patient forms.

New! Ambulatory Referral Order Process

Providers can now place a referral order in EPIC to the Medication Assistance Program.

When placing the order, use referral "Ambulatory Referral to Medication Assistance" and EPIC ID: REF911.

Refer to the linked "Tips & Tricks" document for details.

Anderson

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Anderson Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 765-298-4088
Fax: 317-957-2736
EPIC Pool: Anderson Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
AndersonMAP@eCommunity.com

Anderson - Oncology

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Anderson ONC Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 765-298-4041
Fax: 765-298-4040
EPIC Pool: Anderson ONC Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
AndersonONCMAP@eCommunity.com

Behavioral Health

Inpatient Behavioral Health

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Behavioral Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-2409
Fax: 317-957-2823
EPIC Pool: Behavioral Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
BHMAP@eCommunity.com

Outpatient Behavioral Health

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “AMB BHS Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-2336
Fax: 317-806-5195
EPIC Pool: AMB BHS Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
BHealthMAP@eCommunity.com

Cardiovascular and DOAC

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “AMB DOAC CV Med Assist". Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-887-7261
Fax: 317-957-2782
EPIC Pool: AMB DOAC CV Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
DOACMAP@eCommunity.com

East

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled "East Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-355-6897
Fax: 317-355-6825
EPIC Pool: East Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
EastMAP@eCommunity.com

East - Oncology

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “East Onc Med Assist". Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-355-2324
Fax: 317-957-2821
EPIC Pool: East Onc Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
EastONCMAP@eCommunity.com

Infectious Disease

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “AMB ID Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-1775
Fax: 317-806-1588
EPIC Pool: AMB ID Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
IDMAP@eCommunity.com

Infusion Center

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Infusion Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-2771
Fax: 463-215-1232
EPIC Pool: Infusion Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
infusionMAP@eCommunity.com

Kokomo (Howard Region)

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Kokomo VP Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 765-776-8114
Fax: 317-806-1648
EPIC Pool: Kokomo VP Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
KokomoMAP@eCommunity.com

Kokomo - Oncology

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “Kokomo VP Onc Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 765-776-3555
Fax: 765-453-8080
EPIC Pool: Kokomo VP Onc Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
KokomoONCMAP@eCommunity.com

North

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pools entitled "North Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-1883
Fax: 317-957-2923
EPIC Pool: North Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
NorthMAP@eCommunity.com

North - Oncology

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “North Onc Med Assist". Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-621-4294
Fax: 317-957-2836
EPIC Pool: North Onc Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
NorthOncMAP@eCommunity.com

South and West

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled "South Med Assist”. Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-887-7248
Fax: 317-957-2908
EPIC Pool: South Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
SouthMAP@eCommunity.com

South - Oncology

If a patient with a medication need is identified, contact the Medication Assistance Program Coordinator through the EPIC pool entitled “South Onc Med Assist". Please provide the patient’s name and a brief description of the need.

You will also need to have the patient complete the referral form below. Then scan and send it to the coordinator's e-mail, or fax to the number listed below.

Make the patient aware that they will be contacted via phone within three to four business days after receiving this information to start the process of obtaining medication assistance. The caller ID will state "CHNw Med Assistance." Please encourage the patient to answer this phone call.

Phone: 317-887-7261
Fax: 317-957-2782
EPIC Pool: South Onc Med Assist
EPIC Referral Order: In encounter, choose “Ambulatory Referral to Medication Assistance” (REF911).
SouthOncMAP@eCommunity.com