Programas de asistencia al paciente para Gammagard

Solicite apoyo para su receta con Gammagard

Si califica, los programas a continuación le pueden ser útiles para conseguir Gammagard. 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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My IG Source Program

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

Provienen de: Takeda Pharmaceutical
None
TEL: 855-250-5111
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Solicitudes y Formularios
Medicamentos
  • Gammagard (immune globulin)
Requisitos de Elegibilidad
  • Insurance Status Contact program for details.
  • Those with Part D Elibible? No
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
Solicitud
  • Obtaining Call for prescreening
  • Receiving Varies
  • Returning The completed application must be faxed back.
  • Doctor's Action Varies
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Contact program for details.
Información Adicional
Eligibility determined on a case-by-case basis. This program also provides copay assistance.
Actualizado August 5, 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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HealthWell Foundation Copay Program

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

Provienen de: HealthWell Foundation
P.O. Box 489 Buckeystown, MD 21717
TEL: 800-675-8416
FAX: 800-282-7692
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Gammagard (immune globulin)
Requisitos de Elegibilidad
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income Varies
  • Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
  • U.S. Residency Required? The patient must also be residing in the US.
Solicitud
  • Obtaining Call or complete online
  • Receiving Sent out or may be completed online
  • Returning The completed application must be mailed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section, sign, attach a copy of proof of income
  • Decision Communicated Patient notified in writing
  • Decision Timeframe 3-5 business days
Medicamento
  • Amount/Supply Not applicable
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Good for one year
  • Limit Not specified
  • Re-application New application every 12 months
Información Adicional
This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease. Call for most recent medications as the list is subject to change.
Actualizado July 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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