How Do I Apply for the Medication Assistance Pharmacy?
Getting started is simple. Complete the MAP application and submit the required documentation so our team can determine your eligibility. Once approved, you’ll have access to medications available through the Medication Assistance Pharmacy (MAP) delivered directly to your home.
Ready to Apply?
Before you begin, make sure you meet the eligibility requirements and have all required documents available. Information about eligibility and required documentation can be found in the FAQ section below
There is no cost to apply. Once submitted our team will review your application and contact you if additional information is needed.
Please review our privacy practices before starting your application.
Apply Using a Paper Application
Download and print the MAP application packet. Once completed, submit the application and all required supporting documents using the instructions provided in the packet.
- Mail to : Welvista 121 Greystone Blvd, Columbia, SC 29210
- Scan/Email to: applications@welvista.org
- Fax to: 803-254-0892
To avoid delays in receiving your medications, please double-check that the application form is complete and all supporting documentation is submitted together.
If you need help with filling out a paper application, you can view this quick video.
If you have questions about the proof of income requirements, this video may help explain what is needed.
Apply Online
Complete and submit your MAP application electronically. You will be able to upload your required documents directly through the secure online application. It is important that you have all documentation ready before you begin the online application.
Before You Apply
Before starting your application, make sure you meet the program requirements and have the necessary information available. Taking a few minutes to prepare can help speed up the review process and avoid delays. The approval process typically takes 2-3 weeks.
You must:
- Live in South Carolina
- Do not have health insurance
- Meet household income guidelines
| Persons in Family or Household | Monthly Gross Income | Yearly Gross Income |
| 1 | $3,990 | $47,880 |
| 2 | $5,410 | $64,920 |
| 3 | $6,830 | $81,960 |
| 4 | $8,250 | $99,000 |
| 5 | $9,670 | $116,040 |
| 6 | $11,090 | $133,080 |
| 7 | $12,510 | $150,120 |
| 8 | $13,930 | $167,160 |
| For each additional person, add: | $1,420 | $17,040 |
Have These Documents Ready
To determine eligibility, the Medication Assistance Pharmacy requires documentation to verify your identity, South Carolina residency, and household income.
Required documentation:
- Government-issued photo identification
- Proof of South Carolina residency
- Proof of household income for every income earning member of your home
Having these documents ready before you begin can help ensure your application is processed as quickly as possible.
Need Help Applying?
You don’t have to navigate the application process alone.
Community Outreach Advocates are available throughout South Carolina to help eligible patients complete applications, gather required documents, and answer questions about the enrollment process.
Whether you need assistance getting started or help locating required documentation, our team is here to support you.
Application FAQs
Photo ID is a copy of your driver’s license, state ID card, or passport.
If you don’t have a photo ID you must complete and upload a copy of Welvista’s Attestation of No Photo ID/No Physical Address/ Certificacion de NO identificacion con foto/No direccion fisica.
A document showing current residential address, such as a utility bill, or official piece of mail.
You must provide proof of income documentation for every income earning person in your household. Income can come from various sources. Below are the different ways you can submit that income documentation.
- Job – send 2 current consecutive pay stubs no older than 45 days. With no weeks missing between, showing you/your household’s GROSS income (with deductions listed). Or, you may have your employer sign an employer statement of income / declaracion de ingresos del emleador.
- Commission – please send 1 month of documentation stating commission earnings.
- Odd jobs/work for family/friends/neighbors – Send a signed and dated letter from those you/your household work for stating what work is done, and the monthly income.
- Self-employed – Send your/your household’s most recent Federal 1040 tax return and the Schedule C- Business Profit or Loss worksheet or you may send a completed copy of Welvista’ Self Declaration Form / Formulario de autodeclaracion. It must be printed and signed by both you and a witness and then uploaded to the application.
- Unemployment – Send Unemployment Benefit Statement showing weekly amount received as well as the benefit -year-end date (BYE). It must be clear you are currently receiving benefits.
- Social Security Retirement/Social Security Disability – Send the Social Security New Benefit Amount letter showing the MONTHLY amount received for the CURRENT year. If you are the person applying and you receive Social Security disability you must also send your Notice of Award or entitlement letter from Social Security that shows the month and year you became entitled to disability. You must be within the first two years of disability when you do not qualify for Medicare. If you cannot get a statement from the social security office stating you are not eligible for benefits you may send a completed copy of Welvista’s Attestation of Social Security Ineligibility / Certificado de inelegibilidad para el Seguro Social Form. This form must be signed by a witness (someone other than the patient). You may print it and then upload it to the application.
- Other Retirement/Pension/Annuity – Send the current benefit statement showing the monthly amount received with any deductions OR a copy of Form 1099.
- Child Support/Alimony – Send a copy of a current statement from the clerk of court or a copy of the entire divorce decree stating amount received and how often.
If no one in your home has income, submit a fully completed No Income Form / Sin formulario de ingresos or Exchange for Room & Board Form/cambio de habitación y pensión We need to know how you are paying for your housing, food, and utilities. The person helping you complete the form cannot live in the same household as the patient.
Submit as much completed information as you can. Incomplete applications may experience delays in processing. Our team will contact you if additional documentation is needed.
Once your application is submitted, our team reviews your information and guides you through the enrollment process. It typically takes 2-3 weeks to complete enrollment and receive your approval documentation.
Once eligibility has been verified and enrollment is processed, approval information will be mailed to you.
Enrollment last for up to one year or until you have health insurance.
Yes, as long as you meet the eligibility requirements you may reapply each year.
We will remind you it is time to reapply several weeks before your enrollment ends.
Yes. Healthcare providers and their staff can assist with completing the application and submitting prescriptions once enrollment is approved.