Background The inability to afford medications can lead to nonadherence and uncontrolled disease states. As a result, patients may require an increase in acute healthcare utilization to control potential complications. Qualifying patients can apply for patient assistance programs (PAPs) through various manufacturers to receive medications at little to no cost. Having consistent access to necessary medications can increase adherence and decrease acute care utilization. The purpose of this study was to evaluate the impact of PAP enrollment on healthcare utilization in patients with asthma or chronic obstructive pulmonary disease (COPD). Objectives The primary objective was to compare the number of ED visits and hospitalizations before and after PAP enrollment. Secondary objectives were the estimated ED and hospitalization costs before and after PAP enrollment. Methods The retrospective, observational cohort study included patients of Piedmont Athens Regional Community Care Clinic who received medications for asthma or COPD through PAPs from January 2018 to March 2019. Results A total of 269 patients were screened, and 56 patients met inclusion criteria. Of these, 28 patients had at least one hospital encounter. Primary objective resulted in cumulative number of ED visits decreased from 54 to 7 ( P < 0.001) and cumulative hospitalizations decreased from 13 to 0 ( P < 0.001). Secondary objective showed patients with at least one hospital encounter had a median cost decrease from $4683 to $0 ( P < 0.001). The median hospital acquisition cost per person decreased from $351 to $0 ( P = 0.002). Conclusion A decrease in use of acute healthcare services was observed after PAP enrollment. This was associated with cost savings for patients and the healthcare system.