Financial Assistance

Programs Offered

2024 Every Penny Counts Application Package

Open this form online and type your responses; when complete save the file to your desktop and email it or print it out and fax or mail it.

2024 Greater Minnesota Every Penny Counts Application Package

Open this form online and type your responses; when complete save the file to your desktop and email it or print it out and fax or mail it.

2023 HOPWA Application Package

This form must be printed, filled out and faxed or mailed

Rental Form

Open this form online and type your responses; when complete save the file to your desktop and email it or print it out and fax or mail it.

Drug Co-pay Reimbursement Program

This form must be printed, filled out and faxed or mailed

Instructions

Please return these forms in person, by mail, or by fax to:

Rainbow Health
701 S 4th Avenue
Suite 1500
Minneapolis, MN 55415

Fax: 612-341-4057

Contact Us

In order to serve our clients, we are required to collect some information to determine eligibility. If you are interested in Every Penny Counts Emergency Financial Assistance, please complete and return the forms below. You can also request an application packet by calling 612–331–7733 or 800–565–9028.

AIDSLine

The Minnesota AIDSLine is Minnesota’s statewide information and referral service that can answer your questions about HIV and link you to help. You may reach AIDSLine by phone, text or e-mail.

Call or Text Us at 612-373-2437
E-mail [email protected]