Programas de asistencia al paciente para BiDil

Solicite apoyo para su receta con BiDil

Si califica, los programas a continuación le pueden ser útiles para conseguir BiDil. 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.

Si tiene alguna pregunta favor de comunicarse al teléfono para el programa correspondiente (no PharmacyChecker.com), o vaya a la página del programa.

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Patient Access Network Foundation (PAN)

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

Provienen de: Patient Access Network Foundation
None
TEL: 866-316-7263
FAX: 866-316-7261
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • BiDil tablet (isosorbide dinitrate/hydralazine tablet)
Requisitos de Elegibilidad
  • Insurance Status *See Additional Information section below
  • Those with Part D Elibible? Determined case by case
  • Income Between 400-500% of FPL
  • Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
  • U.S. Residency Required? Must reside and receive treatment in US
Solicitud
  • Obtaining Call or complete online
  • Receiving Complete online or by phone
  • Returning Complete online or by phone
  • Doctor's Action Will be discussed with patient and Doctor after request is received
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor notified in writing
  • Decision Timeframe Within 48 hours
Medicamento
  • Amount/Supply Not applicable
  • Sent To Patient sent card to be used at pharmacy
  • Delivery Time Once approved; shipped same day
  • Refill Proces Patient presents voucher/card to pharmacy for each refill
  • Limit None
  • Re-application New application every 12 months
Información Adicional
*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details.
Actualizado November 22, 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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Arbor Patient Assistance Program

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

Provienen de: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • BiDil tablet (isosorbide dinitrate/hydralazine tablet)
Requisitos de Elegibilidad
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Yes, but contact program for details
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Solicitud
  • Obtaining Call or download
  • Receiving Mailed
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medicamento
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Información Adicional
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Actualizado September 6, 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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