Programas de asistencia al paciente para Hepsera

Solicite apoyo para su receta con Hepsera

Si califica, los programas a continuación le pueden ser útiles para conseguir Hepsera. 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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Advancing Access Program

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

Provienen de: Gilead Sciences, Inc.
PO Box 13185 La Jolla, CA 92039-3185
TEL: 800-226-2056
FAX: 800-216-6857
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Hepsera tablet (adefovir dipivoxil tablet)
Requisitos de Elegibilidad
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Contact program for details.
  • Income Between 400-500% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must also be residing in the US.
Solicitud
  • Obtaining Call, download or apply online
  • Receiving Faxed or mailed
  • Returning The completed application can be faxed or 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 and Doctor notified in writing
  • Decision Timeframe 3-5 business days
Medicamento
  • Amount/Supply Varies. *see below for details
  • Sent To Varies. *see below for details
  • Delivery Time 1-2 business days
  • Refill Proces Patient contacts pharmacy
  • Limit One calendar year
  • Re-application Once a year new application required. Financial documentation may be requested any time
Información Adicional
This program is for outpatient use only. Insurance benefits, claims assistance and/or other reimbursement help is offered. *Viread: Contact program for details **Vistide: Prescription must be included because it will be sent to the doctor's office. This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs. IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company. This program also provides copay assistance.
Actualizado October 8, 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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