Programas de asistencia al paciente para Belviq

Solicite apoyo para su receta con Belviq

Si califica, los programas a continuación le pueden ser útiles para conseguir Belviq. Revise la información para saber si califica. Las solicitudes están disponibles en formato PDF y deben enviarse directamente a quien proporciona el programa de asistencia al paciente.

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Eisai Assistance Program (Belviq)

(Programa 1 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Eisai, Inc.
c/o Rx Outreach PO Box 66536 St. Louis, MO 63166-6536
TEL: 877-318-9557
FAX: 800-875-6591
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Belviq tablet (lorcaserin tablet)
Requisitos de Elegibilidad
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income At or below 150% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must reside in the US, Puerto Rico or the USVI.
Solicitud
  • Obtaining Call, download or apply online
  • Receiving Complete online or by phone
  • Returning Fax, mail or via Online Portal
  • Doctor's Action Give prescription to patient or Fax in prescription
  • Applicant's Action Complete section and sign
  • Decision Communicated Product sent if accepted. If denied patient notified
  • Decision Timeframe Within 2-3 days
Medicamento
  • Amount/Supply Up to 30 day supply
  • Sent To Patient's home
  • Delivery Time Within 3-5 business days
  • Refill Proces Patient contacts pharmacy
  • Limit Varies
  • Re-application New application every 12 months
Información Adicional
For more information please visit www.rxoutreach.org Eisai also offers a Savings Card Program to use at other pharmacies (restrictions apply). For information please visit www.belviq.com/patient/savings
Actualizado October 2, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

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Rx Outreach Medications

(Programa 2 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Rx Outreach
PO Box 66536 St. Louis, MO 63166-6536
TEL: 888-796-1234
FAX: 800-875-6591
Idiomas hablados:
English, Spanish
La Página del Programa
Medicamentos
  • Belviq tablet (lorcaserin tablet)
Requisitos de Elegibilidad
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income At or below 400% of FPL
  • Diagnosis/Medical Criteria Not required
  • U.S. Residency Required? The patient must also be residing in the US.
Solicitud
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning Fax or E-Prescribe online
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section and sign
  • Decision Communicated Medications sent if accepted. If denied patient and doctor notified
  • Decision Timeframe Usually same day
Medicamento
  • Amount/Supply Varies
  • Sent To Doctor's office or patient's home
  • Delivery Time Not specified
  • Refill Proces Company contacts patient to arrange
  • Limit Only limited by manufacturer's guidelines
  • Re-application New application yearly
Información Adicional
Some medications are available for a fee of $20 for up to a 180 day supply. Check the Rx Outreach website for the exact price and most current medication list. Contact Program for Spanish Application(s)/Form(s).
Actualizado September 17, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

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