Are you having difficulty paying for your medications?
Are you forced to choose between paying for your groceries
and paying for your medications?
DON'T let that happen. We can help!
Our company, Special Patients In Need (S.P.I.N.) was formed in 1999 to help people who cannot afford to pay for their medications.
Call us today to see if you qualify to receive a year's supply of your medications for a fraction of what you are currently paying.
Do you qualify for a year's supply of your medications
for much less than what you are currently paying?
Are you medications covered?
Call us today to find out! 1-866-572-7944
If you cannot afford your medicine, if you fall into the Medicare "D" gap/donut hole, or if you simply have no medical prescription coverage, you may be able to receive your medications through pharmaceutical companies at no charge regardless of your age. S.P.I.N. works to facilitate in the procurement of prescription medications necessary to improve the health and well being of our patients and the communities we serve. For a nominal application fee, you can receive a year's supply of your medications.
If you’re like most of our visitors, the first thing you are thinking is that this all sounds too good to be true.
You
may have heard something about how America’s pharmaceutical companies
are giving out prescription medications to America’s uninsured or you may have even seen
Montel Williams promoting the Partnership for Prescription Assistance. His program leaves you hanging. You'll most likely will be required to complete ALL the applications if you went through his company.
All we require from you is your signature! We do ALL the paperwork and applications that are required!
You do nothing but sign your name!We do the rest!
You, like most people we talk to, probably haven’t completely
realized that YOU… yes YOU… can probably get some or all of your
medications deeply discounted in as little as 3 weeks from today… and
continuously receive your medications for as long as you are prescribed them.
Let me assure you, receiving discounted medicine from our prescription assistance program is not too good to be true. It is real and is working for millions of Americans as we speak… and it can happen for you as well with very little effort.
And you are on exactly the right website that will help you through
every step of the process to realizing these amazing savings month after
month and year after year. Our experienced staff has been helping our patients since 1999 with their prescription needs!
OUR MISSION
Our
Mission is to bridge the gap between you, the patient, your doctor and
the pharmaceutical companies when your individual income or your
family’s income becomes a hardship when purchasing your medications. We
have the experience and the information available to us so that no one
falls between the gaps when it comes to affording their medications. Our
efforts to find other programs available in areas to assist the needy
will never cease to be explored! We will continue to help those in need
so that they may live a healthier, happier and productive life. Here are some of the medications that are available on Patient Assistance Programs.
This is just a partial list. Many medicines are available that are not included.
Abilify
Accolate
Accupril
Accuretic
Aceon
Aciphex
Acthar
Activase
Activella
Actonel
Actonel With Calcium
Actoplus Met Tablet ...
Actoplus Met Tablet ...
Actos
Acyclovir Tablet
Adenocard Injection
Adenoscan IV 20ml
Adenoscan IV 30ml
Advair Diskus 100/50
Advair Diskus 250/50
Advair Diskus 500/50
Advicor
Aerobid
Aerobid-M
Aerochamber
Aerochamber With Mas...
Agenerase Capsule
Agenerase Oral Solut...
Aggrenox
Alamast
Albenza Tablet
Albuterol Inhalation...
Albuterol Tablet
Aldactone
Aldara
Aldurazyme
Alimta
Allegra
Allegra D
Allopurinol Tablet
Aloxi
Alphagan P
Alprazolam Tablet
Altace
Alzulfidine 500 Mg
Amaryl
AmBisome Injection
Amerge Tablet
Amiloride With Hydro...
Aminophylline Tablet
Amiodarone Tablet
Amitizia
Amitriptyline Tablet
Amoxil
Anadrol
Anamantle HC
Ancobon
AndroGel
Antivert
Anzemet Injection
Aptivus Capsule
Aralen
Aranesp
Arava
Aricept
Arimidex
Aristocort A Tablet
Arixtra Injection
Armour Thyroid
Aromasin
Arthrotec
Asacol SR
Asmanex Twisthaler
Atacand
Atacand HCT
Atenolol Tablet
Atenolol/chlorthalid...
Atopiclair
Atripla
Atrovent Inhalation ...
Augmentin ES-600TM
Augmentin Oral Suspe...
Augmentin Powder
Augmentin Tablet
Augmentin XR
Avalide
Avandamet Tablet
Avandaryl Tablet
Avandia Tablet
Avapro
Avastin
Avelox
Avodart Soft Gelatin...
Axert
Azasan
Azmacort
Azopt
Baclofen Tabs
Bactroban Cream
Bactroban Ointment
Beconase AQ Nasal Sp...
Belladonna Alkaloids...
Belladonna Alkaloids...
Benazepril HCTZ Tablet
Benazepril Tablet
Benicar
Benicar HCT
Benoquin Cream
BenzaClin
Benzagel
BenzaGel Wash
Benzamycin
Benziq Gel
Benziq Wash
Benztropine Tablet
Betamethasone Diprop...
Betamethasone Valera...
Betamethasone Valera...
Betapace
Betapace AF
Betimol
Betoptic S
Biaxin Filmtab Tablet.
BiCitra
BiCNU
Biltricide
Bion Tears
Bisoprolol/HCTZ Tablet
Boniva
Botox
Brimonidine Tartrate
Bumetanide Tablet
Buphenyl
Bupropion
Bupropion HCL Tablet
Buspirone Tablet
Butalbital APAP Caff...
Byetta Injection
Caduet
Calcijex
Campath
Campral
Camptosar
Canasa
Cancidas
Cantil
Capex Shampoo .01% 4...
Captopril Tablet
Captopril Tablet.
Carac
Carafate
Carbamazepine
Carbatrol
Cardizem LA
Cardura
Carisoprosdol
Carisoprosdol Tablet
Carmol Cream
Carmol Gel
Carmol Lotion
Carmol Scalp Treatme...
Carnitor
Carteolol Hcl
Casodex
Catapres TTS
Cathflo Activase
Caverject
CeeNu
Ceftin Oral Solution
Ceftin Tablet
Celcoxib
Celebrex
Celexa
CellCept
Celontin
Cenestin
Centany
Ceredase
Cerezyme
Chantix
Chlordiazepoxide/cli...
Chlordiazepoxid Tablet
Chlorpropamide Table
Chlorzoxazone Tablet
Cilostazol Tablet
Ciloxan Ointment
Ciloxan Solution
Cimetidine
Cipro HC Otic
Cipro Oral Suspensio...
Cipro Tablet
Cipro XR
Ciprodex
Ciprofloxacin Tablet...
Citalopram Tablet (2...
Clarinex
Clarinex RediTabs
Cleocin
Climara
Climara Pro
Clindagel Topical Ge...
Clobex Lotion .05% 2...
Clonazepam Tablet
Clonidine HCL Tablet
Clozapine
Clozaril
Cognex
Colchicine 0.6mg Tab...
Colestid
Combivent Inhalation...
Combivir Tablet
Comtan
Concerta XR
Copaxone
Copegus
Cordarone
Coreg Tablet
Corgard
Cortef
Corzide
Cosopt
Coumadin
Covera HS
Cozaar
Creon Minimicrospher...
Crestor
Crixivan
Cuprimine
Cyclocort Cream
Cymbalta
Cystadane
Cytogam
Cytomel
Cytotec
Daraprim 2mg Scored ...
Daypro
DDAVP
DDAVP Injection
DDAVP Rhinal Tube
Deconamine
Deconamine SR
Demser
Demulen
Depakene
Depakote ER Tablet
Depakote Sprinkle
Depakote Tablet
Depo Estradiol
Depo Medrol
Depo Provera
Desferal
Detrol
Detrol LA
DHE 45
Diabinese
Diastat
Diazepam Tablet
Diclofenac EC Tablet
Diclofenac Pot. Tablet
Diclofenac Pot. Tablet
Dicyclomine
Dicyclomine Capsule
Dicyclomine Tablet
Didronel 200MG
Didronel 400MG
Diflucan
Digoxin Tablet
Dilantin
Diltiazem ER Capsule
Diovan
Diovan HCT
Diphenoxylate/atropi...
Diprolene AF Cream
Diprolene Lotion
Diprolene Ointment
Ditropan
Ditropan XL
Dovonex
Doxazosin Mesylate T...
Doxepin Capsule
Doxepin Capsules
Doxil
Doxycycline Capsules...
Doxycycline Tablet
Drfferin Gel .1% 45g...
Drisdol
Droxia
Duetact
Duragesic
Dyazide Capsule
Dynacirc CR
Econopred Plus
Effexor
Effexor XR
Efudex
Eldopaque Forte
Eldoquin Forte
Elidel
Ellence
Elmiron
Elocon Cream
Elocon Lotion
Elocon Ointment
Elspar
Emcyt
EMEND
Emla Cream
Emtriva
Enablex
Enalapril Maleate Ta...
Enalapril/HCTZ
Enbrel
Epivir Oral Solution
Epivir Tablet
Epivir-HBV Oral Solu...
Epivir-HBV Tablets
Epogen
Epzicom Tablet
Erbitux
Ertaczo
Erythromycin
Estradiol Tablet
|
Estratest
Estratest HS
Estrogel
Estropipate Tablet
Ethmozine
Ethyol
Etopophos
Evista
Exelon
Eyescrub
Fabrazyme
Famotidine Tablet
Famvir
Faslodex
Felbatol
Feldene
Femara
Fentora
Ferrlecit
Finasteride Tablet
Flagyl
Flarex
Flexeril
Flomax
Flonase Nasal Spray ...
Flovent 110mcg
Flovent 220mcg
Flovent 44mcg
Floxin
Fluconazole Tablet
Fludara
Fluocinonide Cream
Fluoxetine Capsule
Fluphenazine Hydroch...
Flurazepam Tablet
Focalin
Focalin XR
Folgard Rx
Folic Acid Tablet
Foradil Aerolizer
Fortaz Injection
Fortaz Sodium Inject...
Forteo
Fosinopril Tablet
Fosrenol
Fototar Cream
Fragmin
Frova 2.5 MG
Furosemide Tablet
FuzeonGabapentin
Gabitril
Galzin
Gemfibrozil Tablet
Gemzar
Gengraf Capsule
Genotropin
Genteal
Geodon
Gleevec
Glimepiride Tablet
Glipizide ER Tablet
Glipizide Tablet
GlucaGen
Glucagon
Glucotrol
Glucotrol XL
Glutofac-MX
Glutofac-ZX
Glyburide Tablet
Glyburide, Micronize...
Glyburide/Metformin ...
Glynase
Glyquin Cream
Glyquin-MX
Glyset
Grifulvin V Suspensi...
Grifulvin V Tablet
Haldol
Haloperidol Tablet
Hemorrhoidal HC Supp...
Hepsera
Herceptin
Hexalen
Hiprex
Humalog
Humalog 75/25
Humatrope
HUMIRA
Humulin
Humulin L
Humulin N
Humulin N/NPH
Humulin R
Humulin U
Hydralazine
Hydralazine Tablet
Hydrochlorothiazide ...
Hydrochlorothiazide ...
Hydrocortisone Cream...
Hydroxyzine Pamoate...
Hyoscyamine-sl Table...
Hypotears
Hytone Cream
Hytone Lotion
Hyzaar
Iberet-Folic 500
Ibuprofen Tablet
Idamycin
Iletin II
Imdur
Imitrex Injection
Imitrex Nasal Spray
Imitrex Tablet
Imogam
Imovax
Indapamide Tablet
Inderal
Inderide
Inderide LA
Indocin Suspension
Indomethacin Capsule
Infed
Inomax
Inspra
Intal Inhaler
Intal Nebulizer Solu...
Integrilin
Intron-A
Invanz
Invirase
Iopidine
Ipratropium Inhalati...
Iressa
Isopto Carbachol
Isopto Carpine
Isosorbide Dinitrate...
Isosorbide Mononitra...
Isosorbide Mononitra...
ITB Therapy
Januvia
K-Dur
K-Lor
K-lyte
K-lyte CL
K-Lyte DS
K-Tab
Kadian (Ms Contin)
Kaletra Capsules
Kaletra Oral Solutio...
Kaletra Tablets
Kay Ciel
Kayexalate
Kenalog
Kenalog-10
Kenolog-40
Keppra
Kerlone
Kineret
Klaron Lotion
Klor-Con
Kytril
Labetalol HCL Tablet
Lacrisert Ophthalmic...
Lamictal
Lanoxicaps 50mcg
Lanoxin
Lanoxin Elixer Pedia...
Lanoxin Tablet
Lantus
Lescol
Lescol XL
Leukine Liquid
Leukine Lyophilized
Leustatin
Levaquin
Levemir
Levolbunolol HCL
Levothroid
Levothyroxine
Levothyroxine Inject...
Levoxyl
Lexapro
Lexiva Tablet
LidaMantle
LidaMantle HC
Lidoderm
Lipitor
Lisinopril Tablet
Lisinopril Tablet
Lisinopril/HCTZ Tabl...
Lithium Carbonate 30...
Lodosyn
Lopid
Lorazepam Tablet
Lotrisone Cream
Lotrisone Lotion
Lotronex Tablet
Lovastatin Tablet
Lovenox
Lumigan
Lupron
Lyrica
Lysodren
Macrobid 100mg
Macrodantin
Malarone Pediatric T...
Malarone Tablet
Matulane
Mavik Tablet
Maxair
Maxalt
Maxalt-MLT
Maxitrol Suspension
Meclizine Tablet
Medrol
Medroxyprogesterone ...
Meloxicam Tablet
Mephyton
Mepron Suspension
Mestinon
Metformin HCL ER Tab...
Metformin HCL Tablet
Methotrexate
Metipranolol Solutio...
Metoclopramide HCL T...
Metolazone Tablet
Metoprolol Tablet
Metoprolol Tartrate ...
MetroGel
MetroGel .75% 45gm
MetroGel Vaginal
MetroLotion .75% 2oz
Miacalcin
Micardis
Micardis HCT
Micronase
Midamor
Migranal
Minipress
Minitran
Minizide
Minocin
Mirapex
Mirtazepine Tablet
Moduretic
Monistat-Derm
Mustargen
Mycelex
Mycobutin
Mycobutin
Myfortic
Mysoline
Mytelase
Nabumetone Tablet
Nadolol Tablet
Namenda
Naproxen Sodium
Naproxen Tablet
Nardil
Nasacort AQ
Nasarel
Nasonex
Naturetin-5
Navane
Nebupent
Neo-Synephrine
Neoral
Neulasta
Neupogen
Neurontin
Neutra Phos
Neutra-Phos-K
Neutrexin
Nexavar
Nexium
Niacin Tablet 500 Mg...
Niaspan
Nicotrol Inhaler
Nicotrol NS
Nilandron
Nimotop
Nitro-dur
Nitroglycerine Tablet
Nitrolinguel Pumpspr...
Nizoral
Nolvadex
Noritate Cream
Norpace
Nortriptyline HCL Ca...
Norvasc
Norvir Oral Solution
Norvir Soft Gelatin ...
NovoFine 30G (100nee...
Novolin 70/30 InnoLe...
Novolin 70/30 Vials
Novolin N InnoLet
Novolin N Vials
Novolin R InnoLet
Novolin R Vials
NovoLog 10ml Vials
NovoLog 70/30 10ml V...
NovoLog 70/30 FlexPe...
NovoLog FlexPen (5x3...
Nutropin
Nutropin AQ
Nystatin Cream
Nystatin/tr Cream
Ogen
Omeprazole Capsule
Omnicef
Ontak
Orap
Orthovisc
Oxsoralen
Oxsoralen-Ultra
Oxybutynin Chloride
Oxybutynin Tablet |
Oxycontin
OxyFast
OxyIR
Pacerone Pamine
Pancrease
Pancrease MT
Panretin
Parafon Forte
Parnate 10mg Tablets
Paroxetine HCL Table...
Paxil
Paxil CR
PEG-Intron
Pegasys
Penlac
Pentasa
Pentoxifylline 400 M...
Pergonal Injection
Phenergan
Phenytoin Sodium Cap...
PHisoHex
PhosLo Gelcap
Phospholine Iodide
Pilopine HS
Piroxicam Capsule
Plaquenil
Plavix
Plendil
PolyCitra
PolyCitra K
Polycitra LC
Ponstel
Potaba
Potassium Chloride E...
Potassium Chloride E...
Prandin 0.5 Mg
Prandin 1 Mg
Prandin 2 Mg
Pravachol
Precose
Prednisone Tablet
Premarin
Premarin Vaginal Cre...
Premphase
Prempro
Prevacid
Prevacid SoluTab
Previfem Tablet 3 Pa...
Primaquine Phosphate
Primaxin IM
Primaxin IV
Procardia
Procardia XL
Prochlorperazine
Procrit
Prograf
Proleukin
Prolixin
Prometrium
Pronestyl
Pronestyl-SR
Propafenone HCL Tabl...
Propranolol Tablet
Propylthiouracil
Prostigmin
Protonix
Protopic
Protropin
Proventil HFA Inhale...
Proventil UD Solutio...
Prozac
Prozac Weekly
Psorcon E
Pulmicort Respules
Pulmicort Turbuhaler
Pulmozyme
Quinapril
Quinidine Gluconate
Quinine Sulfate
Quixin
Qvar
RabAvert
Ranitidine Tablet
Raptiva
Razadyne
Razadyne ER
Rebetol
Regranex
Relenza
Relpax
Renagel
Requip Tablet
Rescriptor
RespiGam
Restasis
Retin A
Retrovir Capsule
Retrovir Syrup
Retrovir Tablet
Revlimid Capsule
Reyataz
Rhinocort Aqua
Rilutek
Risperdal
Risperdal Consta
Ritalin LA
Rituxan
Robinul
Robinul Forte
Roferon-A
Rosanil Cleasner 6oz
Rosula
Rozerem
RVPaque
Rythmol SR
Saizen
Sandimmune
Sandostatin
Sandostatin Lar Depo...
Serevent Diskus Inha...
Seroquel
Serostim
Sertraline Tablet
Simvastatin Tablet
Singulair
Skelaxin
Skelid
Solage Topical Solut...
Solaquin
Solaquin Forte
Somavert Subcutaneou...
Sotalol Hcl Tablet 8...
Spectazole
Spiriva HandiHaler
Spironolactone
Sporanox
Stalevo
Starlix
Strattera
Stromectol
Sucraid
Sufacet-R
Sular
Sulfamethoxazole/tri...
Sulfasalazine Tablet...
Sulfasalazine Tablet...
Sulindac
Sulindac Tablet150m...
Sustiva
Symbyax
Symlin
Synagis
Synarel
Synthroid Tablet
Synvisc
Syprine
Systane (preservativ...
Systane Eye Drops
Tagamet
Tambocor
Tamoxifen Citrate Ta...
Tarceva
Targretin
Tarka Tablet
Tasmar
Taxotere
Tazorac Cream .05%
Tazorac Cream .1%
Tazorac Gel .05%
Tazorac Gel .1%
Tears Naturale Forte...
Tears Naturale Free
Tears Naturale PM Ey...
Tegretol
Tegretol XR
Temazepam Capsule
Temodar
Tequin
Terazol 3
Terazol 7
Terazosin Capsule
Terazosin Capsule
Teslac
Tessalon Perles
Teveten
Teveten HCT
Thalomid
Theochron
Theophylline ER Tabl...
TheraCys
Thyroid Tablet 15mg
Thyrolar
Tiazac
Tilade Inhaler
Timentin Injection
Timentin Intravenous...
Timolol Maleate Gel
Timolol Maleate Opth...
Timolol Maleate Sol.
Timoptic
Timoptic Ocudose
Timoptic-XE
Tizanidine Hcl Table...
Tizanidine Tablets
TNKase
TOBI
Tobradex Ointment
Tobradex Suspension
Tofranil
Topamax
Toprol XL
Tramadol Tablet
Travatan
Trazodone Tablet
Trecator-SC
Trelstar
Tri-previfem Tablet
Triamcinolone Cream
Triamterene/HCTZ Cap...
Triamterene/HCTZ Tab...
Tricor 145
Tricor 48
Triglide
Trihexyphenidyl Tablet
Trileptal
TriLuma Cream 30gm
Trisenox
Trizivir Tablet
Trusopt Ophthalmic S...
Truvada
Tyzine
Ultracet
Ultram
Ultram ER
Ultrase MT
Unisol 4 Saline Solu...
Urispas
Uroxatral
Urso Forte
Vagifem
Valcyte
Valtrex Caplet
Vantin
Vasodilan
Verapamil Tablet
Verapamil Tablet SR
Vesanoid
VESIcare
Vexol
VFEND
Viagra
Vibramycin
Vigamox
Viokase
Viokase 16
Viracept
Viramune
Viread
Vistaril
Vistide
Vitadye
Voltaren
Vumon
Vytone Cream
Vytorin
Warfarin Tablets
WelChol
Wellbutrin SR
Wellbutrin Tablet
Wellbutrin XL
Xalatan
Xeloda
Xigris
Xolair
Xyrem
Zaditor
Zantac 150 EFFERdose...
Zantac 150 Tablet
Zantac 300 Tablet
Zantac Injection
Zantac Injection (Pr...
Zantac Syrup
Zarontin
Zemplar Capsule
Zemplar IV
Zephiran
Zephrex
Zephrex LA
Zerit
Zetia
Ziagen Oral Solution
Ziagen Tablet
Zinacef Injection
Zinecard
Zithromax
Zofran ODT
Zofran Tablet
Zoladex
Zoloft
Zometa
Zomig Nasal Spray
Zomig Tablet
Zomig ZMT
Zonegran
Zovirax
Zovirax (capsules)
Zovirax (suspension)
Zovirax (tablets)
Zovirax Cream
Zovirax Ointment
Zyban Suspended Rele...
Zyprexa
Zyprexa Zydis
Zyvox |
Do you Qualify for Patient Assistance Program Help with Your Prescription Medication?
Are the high costs for prescription drugs at your pharmacy
creating a burden on your finances? Are you uninsured? Would you like to
know if you qualify for free medication through a Patient Assistance
Program?
There are over 250 Patient Assistance Programs and each has
different guidelines to qualify. Though you will generally qualify if
you meet these three conditions:
- Be a U.S. Resident
- Not be insured for outpatient prescription drugs (including Medicaid)
- Have an income level that causes hardship when paying for retail prescriptions
The exact definition of economic “hardship” varies with each
Patient Assistance Program, though most adhere to a formula related to
the Federal Poverty guidelines. If your income is 200% below the Federal
Poverty guidelines, then you will most likely qualify. The qualifying
income levels for each state are outlined below.
200% of Federal Poverty Guidelines (2011)
| Persons in Family |
48 Continental States and D.C. |
Alaska |
Hawaii |
| 1 |
$21,780 |
$27,200 |
$25,080 |
| 2 |
29,420 |
36,760 |
33,860 |
| 3 |
37,060 |
46,320 |
42,640 |
| 4 |
44,700 |
55,880 |
51,420 |
| 5 |
52,340 |
65,440 |
60,200 |
| 6 |
59,980 |
59,980 |
68,980 |
| 7 |
67,620 |
67,620 |
77,760 |
| 8 |
75,260 |
94,120 |
86,540 |
| For each additional person, add |
7,640 |
9,560 |
8,780 |
Enrollment is fast and easy. Call us today to see if you qualify 1-866-572-7944.
Important Information and Frequently Asked Questions
What are Patient Assistance Programs?
Commonly referred to as PAPs, Patient Assistance Programs are services offered by pharmaceutical companies for those who cannot afford their medication. Patient assistance programs are available to low-income individuals or families who are under-insured or uninsured and are provided to those who meet the eligibility guidelines. Assistance may range from reduced cost of drugs to free medicine. Each drug that a company offers will have its own unique program and may even have a different eligibility requirement than the other drugs they offer. As there is no unified standard of designation for these programs, you may also see them referred to as medication assistance programs, indigent drug programs, and charitable drug programs.
Patient Assistance Programs are not mandated or managed by the federal government and are offered as a free service by the pharmaceutical industry. Nearly all of the major pharmaceutical companies provide specific programs for their most popular drugs. As each program is different, please take a look through our comprehensive database which allows you to search by drug or company name to find your medicines specific patient assistance program. Each profile will provide you with detailed information on how their specific program can assist you with your medication bill and what requirements are needed to qualify for assistance.
Are there general eligibility requirements?
After properly identifying the pharmaceutical company who offers the medicine you would like assistance with, you can begin the the enrollment process. The initial enrollment form along with detailed company information and eligibility requirements are listed in each profile in our database.
Select the enrollment form from the right side of the profile and proceed to either fill it out online or print a hard copy to fill out manually. You should always keep record of the form you have submitted, including the date.
If the form is not available for the medicine you have selected, that indicates either the company only distributes their form through regular mail or they require contact from your primary care physician before providing the form. Contacting your physician allows the company to screen for eligibility before the claim is submitted.
Once the company receives your enrollment form, they will review your eligibility. If you qualify, they will provide you the medication by sending it to your mailing address, your physicians office, or a local pharmacy. If you do not qualify, many companies will not provide you any response to your submitted form.
What steps do you need to take?
Yes. Although eligibility differs from program to program, they all have three specific criteria in common.
· Income:
To qualify for any patient assistance program, your total household income must be less than 200% of the Federal Poverty Level.
· Prescription Coverage:
Prescription assistance programs require that you do not currently subscribe to private or public sources of prescription coverage.
· Residence:
You must be a United States resident or citizen to be eligible for any of these programs.
You should check each companies profile before assuming that they do not request additional information for eligibility. Many companies only require the three criteria listed above to verify eligibility in their programs.
What other material will I need to provide besides the enrollment form?
Many pharmaceutical companies will require additional material to be submitted along with your completed enrollment form. As stated before, there are no unified guidelines for what each company requests, but you can expect that many of them will require similar information. Below you will find a list of the information most commonly requested by patient assistance programs.
· Income:
Many companies will request that you provide proof of income. The following are examples of acceptable material to submit for this request: Federal or State tax statements, pay stubs, or bank statements.
· Coverage:
As the general eligibility guidelines exclude applicants currently enrolled in prescription coverage programs, you may be required to provide insurance related information. The following are examples of acceptable material to submit for this request: current insurance plan statement, a rejection letter from Medicaid, or a rejection letter from an insurance company.
· Physician Related:
It may be required that your physician provide additional information besides what was requested on the enrollment form. Your physician may be requested to provide: a prescription for the specific medication, doctors information, or their signature.
Each company may request specific material from you in addition to your enrollment form. Please take the time to review each companies profile in our database before you submit your finished application.
What is required of my physician during the enrollment process?
While they're are some enrollment processes that do not require interaction from your physician; many request that they provide answers to question on the form or directly sign it. Each patient assistance program enrollment will detail what information they will need from your physician. As stated before, there are no unified guidelines for what each company requests, however you can expect that many will require similar information. Below you will find a list of the information most commonly requested from your physician.
· Patient Diagnosis:
Required in the same manor as an insurance company requests when authorizing medication for a patient. The diagnosis is used to determine if the specific medicine in question is the best option for the patient.
· Prescription:
In any situation that medication will be supplied to a patient, a prescription from their physician is necessary. Enrollment processes that ask for this information will require the patient/physician to attach the prescription to the form or provide the prescription to the pharmacy where the medication will be received.
Some enrollment forms can only be acquired by having the physician contact the pharmaceutical company directly. By making contact with your physician, the company can determine eligibility before the form has been submitted. Please see the profile for the patient assistance program you're inquiring about for further details on what is required from your physician.
Is there any cost associated with patient assistance programs?
In most cases, there is no cost associated with patient assistance programs. If there are any costs for the program, it will be displayed in the profile for the pharmaceutical company whose medication you are inquiring about. Many PAP's provide their medication completely free or at a significant discount off the uninsured cost. If you acquire your medication through a local pharmacy, you may be charged up to a $25 co-pay. This is not imposed by the pharmaceutical company, but by the pharmacy you are working with.
When should I expect to receive my medication?
After your enrollment application has been accepted to the patient assistance program, it may take up to 6 weeks before you start receiving your medication. If the enrollment form stated that your medicine will be sent to the nearest pharmacy or your doctors office, it is recommenced that you provide them with your most recent contact information so they can inform you that your medication has arrived.
Please note: It is not guaranteed that you will be contacted if your enrollment form has been rejected. Make sure to save information detailed by the pharmaceutical company on how to check the status of your application.
How are refills handled?
To request a refill, you or your physician will have to contact the pharmaceutical company. Who contacts the company is dependent on the requirements of the PAP that you have enrolled in. Please keep in mind that you may only request a refill during your enrollment period. Each program will clearly state how often you need to resubmit your application. Failure to do so will result in a termination of the provided services and a rejection of your refill request. As each program is different, please refer to your patient assistance program's profile in our database for information regarding the refill process and enrollment duration.
Does having health insurance disqualify me from eligibility?
While belonging to a prescription coverage program renders you ineligible for any patient assistance program, it is not universal as to whether having health insurance will do the same. Although having health insurance will not effect most patient assistance programs, some do require that you do not have any form of public or private coverage. The company profiles within our database will provide you with the eligibility requirements for the specific PAP you are inquiring about, including their requirements regarding health insurance.
Am I still eligible if I have used all of my current prescription coverage?
Once you have used all of your prescription coverage, you are no longer considered covered as it provides you no use. It is recommended that you wait until you have received documentation stating that your prescription coverage plan has been exceeded before you submit your application for enrollment. Even though many patient assistance programs will not require it, you should provide a copy of that statement along with your enrollment application to prevent an accidental disqualification.
Will having Medicare Part D disqualify me?
Most patient assistance programs disqualify all those eligible for the full low income subsidy through Medicare Part D. If you do not qualify for the full low income subsidy, you should attach documentation from Social Security stating that you are ineligible, to your enrollment form. Please keep in mind that this information varies greatly between different companies and is subject to change without notice. If the profile for the patient assistance program in our database states that you are disqualified for having Medicare Part D, it is recommended that you contact the company directly to request your case be further reviewed. It is not uncommon for exceptions to be made for those facing financial difficulties.
Why has my enrollment been disqualified and what can I do about it?
Unfortunately not every enrollment application to a patient assistance program will be accepted. As these services are provided for free by the pharmaceutical companies, it is at their discretion who they reject and for what reason. It is unlikely that you will be disqualified for anything other than failing to meet all eligibility requirements.
It is possible to have the rejection overturned by submitting your application for appeal. You should request that your physician provide you with a letter of detailing under what circumstances your case should be reconsidered. After making copies of the material for your own record, send a fresh copy of your application, rejected application, and your physicians letter to the address listed for the patient assistance program with “ATTN: Appeals Department” on the front of the envelope.

Special Patients In Need
Post Office Box 1315
Moultrie, Georgia 31776
SpecialPatientsInNeed@windstream.net
Phone: 1-229-798-4488
Toll Free: 1-866-572-7944
Facsimile: 1-229-873-9727