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Patient Assistance Program Novo Nordisk Inc PO Box 2026

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The Novo Nordisk Patient Assistance Program (PAP) offers free medication to eligible patients who apply through a detailed application process. The program requires verification of patient eligibility and income, and medications are shipped to a licensed healthcare professional for dispensing. Patients must not seek reimbursement from other insurance while receiving PAP benefits, and consent is required for the collection of personal health information. The application includes sections for patient details, prescriber information, and various consents related to health data and communication.

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Click ‘Get Form’ to open the Patient Assistance Program application in the editor.
Begin by selecting either 'New Application' or 'Re-Enrollment' at the top of the form. Ensure you check one option as it is required.
Fill in your personal details in the Patient Section, including your first name, last name, street address (no PO Box), city, state, zip code, phone number, and email. Remember that fields marked with an asterisk (*) are mandatory.
Complete Section A by providing your date of birth (DOB), prescriber’s information, and whether you have any prescription drug coverage. If applicable, check all relevant options.
Proceed to Sections B through I where you will provide consent for income verification and health information collection. Make sure to check the boxes and sign where indicated.
Review all sections for completeness before submitting. Attach any additional documentation if required.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Where do I mail the Novo Nordisk patient assistance program?

Take your application and proof of income to your health care provider and have them: Complete the Prescriber and Rx sections of the application. Sign and date the application. Fax the completed application and proof of income to 1‑866‑441‑4190, or mail them to Novo Nordisk Inc., PO Box 370, Somerville, NJ 08876.

Does Novo Nordisk have a patient assistance program?

If youre struggling with prescription drug costs, PAPs can help you afford medication whether you have health insurance or not. Pharmaceutical companies, nonprofit organizations, and government agencies, provide this type of financial assistance. Some programs offer complete coverage, while others give you a discount.

How do I reorder my Novo Nordisk patient assistance program?

Reorders can be requested by completing and submitting the Refill Request Form below or by calling Novo Nordisk toll-free at 1-866-310-7549. Patients can renew each year for as long as they qualify. For uninsured patients, an approved application is valid for 12 months.

Who is eligible for Ozempic assistance?

It covers manufacturer PAPs like BI Cares for Jardiance, Lilly Cares for Trulicity, and Novocare for Ozempic, Rybesus, and Victoza. Patients: If you are uninsured, underinsured, or have Medicare Part D prescription drug benefits and cannot afford your medication, you may qualify.

What is the Novo Nordisk patient assistance program?

The Novo Nordisk Patient Assistance Program (PAP) provides medication at no charge to applicants who qualify under the PAP guidelines. Requested medications or devices are shipped to a licensed health care professional for dispensing, up to a 120-day supply.

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What can I do if I cant afford my Ozempic?

Ozempic offers a variety of support programs to help you manage your type 2 diabetes. Novo Nordisk provides patient assistance for those who qualify. Call 1-866-310-7549 or visit our Let Us Help page to learn more about Novo Nordisk assistance programs.

Is the patient assistance program legit?

Need help affording your medication? If eligible, you may be able to get your diabetes medicine free of charge. The Novo Nordisk Patient Assistance Program (PAP) provides free medicine to those who qualify without any registration or monthly fees.