Step 1 of 12

Annual Re-enrollment for Assistance

It is now time to re-enroll.
With our proprietary enrollment system, we have streamlined the re-enrollment process to better serve our clients. Upon submission of your re-enrollment, Good Days will process your request to determine eligibility for funding.
      NOTE: Eligibility is determined on a first-come, first-served basis subject to available funding.

Required Information

We will need the following information to re-enroll:

  • Patient Social Security Number, or Patient ID
  • Patient Year of Birth
  • Patient household size and household income
  • Patient Diagnosis

Please note, patients who are reapplying for copayment assistance must have at least 50% coverage or more to be eligible, excluding deductibles. 

You may re-enroll a patient in our system whether you are the client or are the client’s advocate.

 

To continue with your re-enrollment request, please select “Next”