|Program Name:||Actavis U.S. Patient Assistance Program|
|How do I apply?||Ask your doctor to help you submit an application. You can find the form on the program website, or request one by calling 1-800-851-0758.|
|What are the benefits?||You can enroll for 12 months at a time, and your medication will be shipped to your doctor or pharmacy every 90 days at no charge if you are approved.|
|What are the restrictions?||You will need a valid prescription, proof of gross monthly househould income, and a copy of your LIS denial letter (Medicare Part D only). Please contact the program for more information about income eligibility requirements.|
|Keep in mind||N/A|
|Program Name:||Rapaflo Patient Assistance Program|
|How do I apply?||Ask your doctor to help you fill out an application. You can find the form on the program website and can be submitted by mail or fax.|
|What are the benefits?||You can receive up to a 90 day supply of your medication at no cost.|
|What are the restrictions?||Most people without insurance and with limited incomes will qualify. You will need a valid prescription and proof of househould income.|
|Keep in mind||N/A|
You may find that filling a 90-day supply will reduce your total cost for this prescription. As an added bonus, you'll make fewer trips to the pharmacy, saving you time and money.
A couple of things to keep in mind: first, you may need a new prescription from your doctor that allows you to fill a 90-day quantity. Your insurance plan may also require that you fill through a mail order pharmacy for fills of more than a 30-day supply.
There may be other prescriptions in the same class (that work in the same way) that could treat your condition just as well at a much lower cost.
If you're taking an expensive brand-name-only drug, it may be worth asking your doctor if there are any other less expensive, generic, or over-the-counter options that might work for you.