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The Otsuka Patient Assistance Foundation offers a no-cost medication program for eligible patients prescribed specific Otsuka medications, including ABILIFY and REXULTI. The application process requires patients or their representatives to complete various sections of the form, provide financial documentation, and have their healthcare provider fill out additional sections. Completed forms can be submitted via fax or mail, and assistance is available through a dedicated patient coordinator.

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Who is eligible for the patient assistance program?

Eligibility and enrollment Be a US citizen or legal resident. Have a total household income at or below 400% of the federal poverty level. Must be uninsured, or have Medicare. Note: if you have private or commercial insurance, you are not eligible for the PAP.

How can I get Rexulti for free?

If youve been prescribed REXULTI and have commercial insurance, you may be eligible for the REXULTI Savings Card. That means you could pay as little as: $0 for REXULTI refills. $0 for 90-day prescriptions.

What is the income limit for AZ and ME patient assistance?

You may be eligible if you meet the following criteria: 1. You have an annual household income* at or below: $35,000 for a single person $48,000 for a family of two $60,000 for a family of three $70,000 for a family of four $80,000 for a family of five * Income limits may be higher in Alaska and Hawaii.

What is the Lupin patient assistance program?

Lupin Pharmaceuticals Patient Assistance Program Provides coverage for Solosec and other qualifying pharmaceuticals. Call (877) 438-9759 or email solosec@truaxpatientservices.com for program application materials.

Who funds patient assistance programs?

Pharmaceutical manufacturers may sponsor patient assistance programs (PAPs) that provide financial assistance or drug free product (through in-kind product donations) to low income individuals to augment any existing prescription drug coverage.

otsuka patient assistance application form

Otsuka Patient Assistance application pdf REXULTI Patient Assistance form pdf REXULTI Patient Assistance application ABILIFY Patient Assistance application form Otsuka Patient Assistance login Otsuka Patient Assistance income guidelines Otsuka Patient Assistance Attestation Form Otsuka Patient Assistance phone number

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What is the income limit for Novo Nordisk patient assistance program?

Who is eligible for this program? Patients must be a US citizen or legal resident, must have a total household income at or below 400% of the federal poverty level, and must be uninsured or have Medicare. Note: Patients with private or commercial insurance are not eligible for the PAP.

What is the Equetro patient Assistance Program?

The Equetro Patient Assistance Program provides Equetro at no charge to eligible patients. To qualify, a patient must be a resident of the United States and meet certain financial requirements. Once approved, patients will receive a 3-month supply of Equetro (delivered to their healthcare providers office).

What is the Otsuka patient assistance program?

The Otsuka Patient Assistance Foundation, Inc (OPAF), is a nonprofit organization that assists underinsured and uninsured patients who have been prescribed Otsuka medications. OPAF has specific eligibility criteria that applicants must meet prior to their approval for assistance.

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Who is eligible for the patient assistance program?

How can I get Rexulti for free?

What is the income limit for AZ and ME patient assistance?

What is the Lupin patient assistance program?

Who funds patient assistance programs?

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What is the income limit for Novo Nordisk patient assistance program?

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