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2006 Guide to Affordable Prescription Drugs
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Sample of medication list:
GLUCOPHAGE XR
49: Bristol-Meyers Squibb Patient Assistance Foundation, Inc.
210: RX Outreach
GLUCOTROL
64: Connection to Care
177: Pfizer Pfriends
210: RX Outreach
235: Together Rx Access
257: XUBEX Patient Assistance
Program
GLUCOTROL XL
64: Connection to Care
177: Pfizer Pfriends
210: RX Outreach
235: Together Rx Access
GLUTAREX-1 Powder
209: Ross Metabolic Formula and ELECARE Patient Assistance Program
GLUTAREX-2 Powder
209: Ross Metabolic Formula and ELECARE Patient Assistance Program
GLUTOFAC-MX Caplets
47: Bradley Pharmaceuticals Indigent Patient Program
GLUTOFAC-ZF Caplets
47: Bradley Pharmaceuticals Indigent Patient Program
GLYNASE
64: Connection to Care
177: Pfizer Pfriends
210: RX Outreach
235: Together Rx Access
257: XUBEX Patient Assistance
Program
GLYQUIN Cream
243: Valeant Patient Assistance Program
GLYQUIN XM Cream
243: Valeant Patient Assistance Program
GLYSET
64: Connection to Care
177: Pfizer Pfriends
235: Together Rx Access
GONAL-F Prefilled Pen
219: Serono Compassionate Care Program for Infertility
GRIFULVIN V Microsize Oral Suspension or Tablets
127: Johnson+Johnson Patient Assistance Program
235: Together Rx Access
H
HALDOL DECANOATE Injection
127: Johnson+Johnson Patient Assistance Program
235: Together Rx Access
HALDOL Injection
127: Johnson+Johnson Patient Assistance Program
HECTOROL
114: HECTOROL Patient Assistance Program
HELIXATE FS
258: ZBL Behring Patient Assistance Program
HEMOFIL-M
36: Baxter Factor Plus Program
HEPSERA
113: Gilead Advancing Access™
HERCEPTIN
107: Genentech Access to Care Foundation
HEXALEN
150: MGI Pharma Patient assistance Program
HIPREX
217: Sanofi Adventis Patient Assistance Program
Sample list of programs for medications
252: WINRHO Patient Assistance Program
Type: PAP
Phone: 1-800-494-6746
Eligibility: Patient must not have prescription coverage and must not qualify for any state or federal prescription coverage. Contact program for income guidelines.
253: Wyeth Oncology Reimbursement Program
Type: PAP
Phone: 1-888-638-6342
Eligibility: Call program for income and insurance guidelines.
254: Wyeth Pharmaceutical Assistance Foundation
Type: PAP
Phone: 1-800-568-9938
Website: www.wyeth.com/contact/contact_assist.asp
Eligibility: Patient must not have prescription coverage and must not qualify for any state or federal prescription coverage. Maximum income is 200% of the FPL ($19,600 single, $26,400 couple, add $6,800 for each additional family member).
255: Xcel Patient Assistance Program
Type: PAP
Phone: 1-800-511-2120
Eligibility: Patient must not have prescription coverage and must not qualify for any state or federal prescription coverage. Maximum income is 200% of the FPL ($19,600 single, $26,400 couple, add $6,800 for each additional family member).
256: XTSP-Support Program
Type: PAP
Phone: 1-877-522-4357
Website: Main website: www.xigris.com Program website: www.xigris.com/resources/reimbursement.jsp?reqNavId=4.8
Eligibility: Patient must not have prescription coverage and must not be eligible for state or federal prescription aid. Maximum income of $29,000 for single, $39,600 couple.
Comments: If accepted into this program, the program will reimburse the hospital for the XIGRIS you used, thus you won't be billed for the medication. Call the program's toll-free number for exact details.
257: XUBEX Patient Assistance Program
Type: Flat-fee
Phone: 1-866-699-8239
Website: www.xubex.com
Eligibility: This program lists income guidelines only. It does not publish any restrictions for those with prescription coverage. Maximum income level of $24,674 (single), $32,141 (couple), $40,890 (household of 3), or $48,675 (household of 4) This program does not provide free medications. They do provide generic medication at a very low price. There are two price level depending on the medication you need. Class 1 medications will cost $20.00 for a 90 day supply. Class 2 medications will cost $30.00 for a 90 day supply. All prescriptions are filled with generic medications. A $3.85 shipping and handling charge applies to each order placed.
Comments: You may qualify even if you have prescription coverage as long as you meet the income limits. Call the program's toll-free number for more information.
258: ZBL Behring Patient Assistance Program
Type: PAP
Phone: 1-800-676-4266
Website: Main Website: www.zlbberhing.com PAP website: www.zlbbehring.com/ab/n47979/PHCFeaturedSection1.htm
Eligibility: Each case is reviewed on an individual basis. The program is for anyone who cannot afford their medications, this includes those with insurance who are experiencing a financial hardship. Call the program's toll-free number and speak with a representative who can help you determine if you qualify for help.
259: ZEMPLAR Resource Center
Type: PAP
Phone: 1-877-936-7527
Website: www.zemplar.com/HCP/CAP_resource_center.html
Eligibility: Patient must not have prescription coverage for ZEMPLAR. Call for assistance in determining eligibility.
260: ZEMPLAR Reimbursement Services
Type: Reimbursement
Phone: 1-877-936-7527
Website: www.zemplar.com/HCP/CAP_resource_center.html
Eligibility: Must have prescription coverage. The program will help you work with your insurance company to receive proper coverage for their medications.
261: ZOLOFT Rebate
Type: Rebate
Website: www.zoloft.com
Eligibility: Receive a rebate of up to $10. See website for details.
sample of list of state programs
Nationwide
For a listing of free and low-cost, clinics throughout the United States visit the Unite for Sight Free Clinic Directory at www.uniteforsight.org/freeclinics.php
Low-cost health insurance for children is available in all 50 states. To learn about the program in your state call 1-877-KIDS-NOW or visit www.insurekidsnow.gov
Alabama
Program: Alabama AIDS Drug Assistance Program
Phone: 1-800-228-0469
Website: www.adph.org/AIDS/default.asp?TemplateNbr=0&DeptID=96&TemplateId=551
Eligibility: Must be diagnosed with HIV/AIDS. Must be a resident of Alabama. Must not be eligible for Medicare or Medicaid. Maximum income is 250% FPL ($24,500 single, $33,000 couple, add $8,500 for each additional family member). If you have private prescription insurance, you may be eligible for this program if your insurance pays less than 50% of your medication costs. There is often a waiting list for this program.
Services: The program provides low-cost or free medications commonly used by those with HIV/AIDS. Contact the program for a complete list of medications.
Program: ALLKIDS
Phone: 1-888-373-5437
Website: www.adph.org/ALLKIDS/
Eligibility: Contact the program for eligibility requirements and income guidelines.
Services: This program offers low-cost comprehensive health insurance for children 18 and under.
Program: Family Services Center
Phone: 1-334-673-3940
Website: www.dothan.k12.al.us/asfsc/family_health_clinic.htm
Eligibility: Must be a resident of Houston County. Must not have health insurance. Maximum income is 150% of the FPL ($14,700 single, $19,800 couple, add $5,100 for each additional family member).
Services: Provides free health care.
Alaska
Program: Alaska AIDS Drug Assistance Program
Phone: 1-800-478-3437
Website: www.epi.hss.state.ak.us/hivstd/hiv.stm
Eligibility: Must have HIV/AIDS. Must be a resident of Alaska for at least 30 days. Must not qualify for any other prescription assistance. Income limit is 300% of FPL ($36,750 single, $49,500 couple, add $12,750 for each additional family member). Contact program for complete guidelines.
Services: The program provides low-cost or free medications commonly used by those with HIV/AIDS. Contact the program for a complete list of medications.
Program: Alaska SeniorCare Program
Phone: 1-888-352-4150
Website: www.hss.state.ak.us/dsds/seniorcaresio.htm
Eligibility: Must be over 65. Income limit is $20,913 for single, $28,053 for couples. Liquid asset limit of $50,000 for single and $100,000 for couples.
Services: This program covers the monthly premiums and the annual deductible for Medicare prescription drug plans.
Program: Chronic and Acute Medical Assistance
Phone: 1-800-780-9972
Website: www.hss.state.ak.us/dhcs/CAMA/default.htm
Eligibility: Patient must be diagnosed with a terminal illness, cancer requiring chemotherapy, chronic diabetes, diabetes insipidus, chronic seizure disorders, chronic mental illness, or chronic hypertension. Must not be eligible for Medicaid or other insurance assistance programs. Must earn $300 a month or less for single, $400 a month or less for couple. Must have less than $500 in savings or bank account. Contact program for complete guidelines.
Services: The program covers up to 3 prescriptions per month (no more than a 30-day supply of any one drug), physician services, chemotherapy, outpatient lab serves, and X-rays. There is a $1.00 co-pay on medications. Contact program for complete details.
Program: Denali Kidcare
Phone: 1-888-318-8890
Website: www.hss.state.ak.us/dhcs/DenaliKidCare/default.htm
Eligibility: This program is for children 18 and younger and pregnant women. Contact the program for income guidelines. Those with insurance may still be eligible.
Services: Program provides affordable health insurance.
sample of programs for medical conditions
Childhood Illness/Disease - Chronic
Program: Spare Key
Services available in: Minnesota
Phone: 1-651-457-2609
Website: www.sparekey.org/
Qualifications: Severity of illness or injury and length of time in hospital are considered in the application process. Contact the program for complete details.
Services: The program's goal is to help families spend time with critically ill or seriously injured children. Assistance is available for mortgage payments. Contact the program for complete details.
Program: Godstock
Services available in: North Carolina
Phone: 1-704-857-7011
Website: www.godstock.org/
Qualifications: For families of chronically ill children living in North Carolina. Contact the program for details.
Services: Provides non-medical financial assistance for necessities such as mortgage payments, car payments, insurance, power, water, gas/heat, etc.
Childhood Illness/Disease - Serious Illness
Program: Ann and Pinky Sohn Fund - Chai Lifeline
Services available in: Nationwide
Phone: 1-877-CHAI-LIFE
Website: www.chailifeline.org/
Qualifications: Contact the program for details. Program has four centers throughout the United States.
Services: Provides financial assistance for non-medical expenses that result from a child's illness. Also provides a program that gives toy store gift cards during Chanukah season for hospitalized or homebound seriously ill children. Contact the program for complete details.
Childhood Illness/Disease - Sudden Illness
Program: Spare Key
Services available in: Minnesota
Phone: 1-651-457-2611
Website: www.sparekey.org/
Qualifications: Severity of illness or injury and length of time in hospital are considered in the application process. Contact the program for complete details.
Services: The program's goal is to help families spend time with critically ill or seriously injured children. Assistance is available for mortgage payments. Contact the program for complete details.
Children with disabilities
Program: Disabled Children's Relief Fund
Services available in: Nationwide
Phone: Write to: Disabled Children's Relief Fund
P.O. Box 89
Freeport, New York 11520
Website: www.dcrf.com/index.html
Qualifications: Contact the program for eligibility requirements.
Services: Contact the program for details.
Colorectal Carcinoma
Program: HealthWell Foundation®
Services available in: Nationwide
Phone: 1-800-675-8420
Website: www.healthwellfoundation.org/index.aspx
Qualifications: Family income up to 400% of the FPL ($39,000 single, $52,800 couple, $66,400 family of three, add $13,600 for each additional family member) may qualify. Patients with or without insurance may qualify. Contact the program for more detail.
Services: Contact the program for details.
Cutaneous T-Cell Lymphoma
Program: Cutaneous T-Cell Lymphoma Fund
Services available in: Nationwide
Phone: 1-866-316-7268
Website: www.patientaccessnetwork.org/
Qualifications: Call the program for income and insurance guidelines.
Services: Program covers out-of-pocket costs, premiums, and co-pays. Contact the program for benefits information.
Program: HealthWell Foundation®
Services available in: Nationwide
Phone: 1-800-675-8421
Website: www.healthwellfoundation.org/index.aspx
Qualifications: Family income up to 400% of the FPL ($39,000 single, $52,800 couple, $66,400 family of three, add $13,600 for each additional family member) may qualify. Patients with or without insurance may qualify. Contact the program for more detail.
Services: Contact the program for details.
Cystic Fibrosis
Program: Comprehensive Care Program for CF™
Services available in: Nationwide
Phone: 1-866-292-2679
Website: www.scandipharm.com/comprehensivecare.php?lang=1
Qualifications: Patient must have Cystic Fibrosis. Patient must have a prescription for ULTRASE or ULTRASE MT.
Services: Program provides 24 envelopes of SCANDISHAKE or two 8-ounce canisters of SCANDICAL, ADEKs (60 tablets or one 60mL bottle), a certificate for a FLUTTER mucus clearance device, and a book called Cystic fibrosis: A Guide for Patient and Family.
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