Programas de asistencia al paciente para Noritate

Solicite apoyo para su receta con Noritate

Si califica, los programas a continuación le pueden ser útiles para conseguir Noritate. 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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Bausch Health Patient Assistance Program

(Programa 1 de 4 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Bausch Health Companies, Inc.
P.O. Box 6122 Lawrenceville, NJ 08648
TEL: 833-862-8727
FAX: 866-777-5705
Idiomas hablados:
English
La Página del Programa
Medicamentos
  • Noritate (metronidazole)
Requisitos de Elegibilidad
  • Insurance Status Must have no prescription coverage for needed medication
  • Those with Part D Elibible? Determined case by case
  • Income Based on FPL
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must be a US resident and treated by a US licensed healthcare provider
Solicitud
  • Obtaining Call
  • Receiving Faxed
  • 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 Not specified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Varies
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit One year
  • Re-application New application yearly
Información Adicional
Hardship appeals for patients residing in Puerto Rico will be reviewed on a case-by-case basis. Call for information on the most recent medications as the list is subject to change.
Actualizado June 4, 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 4 — 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
  • Vandazole (metronidazole)
Requisitos de Elegibilidad
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income At or below 300% 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 June 3, 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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Pfizer Savings Program

(Programa 3 de 4 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Pfizer, Inc.
PO Box 66585 St. Louis, MO 63166-6585
TEL: 866-706-2400
FAX: 866-470-1748
Idiomas hablados:
English, Spanish
La Página del Programa
Medicamentos
  • Flagyl (metronidazole)
Requisitos de Elegibilidad
  • Insurance Status Must be uninsured
  • Those with Part D Elibible? No
  • Income Varies
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? Must be residing in the US or US territory
Solicitud
  • Obtaining Call for prescreening
  • Receiving There is no application
  • Returning The completed application's destination is not applicable
  • Doctor's Action Give prescription to patient
  • Applicant's Action Call to enroll
  • Decision Communicated Decision made during phone screening
  • Decision Timeframe Decision made during phone screening
Medicamento
  • Amount/Supply Contact the program for more details.
  • Sent To Pharmacy
  • Delivery Time Not applicable
  • Refill Proces Varies per medication
  • Limit None
  • Re-application New enrollment every 12 months
Información Adicional
This program provides uninsured patients with savings on their prescriptions at the pharmacy. Pfizer also has programs that provide eligible patients with insurance support, copay assistance, and medicines for free. Contact Pfizer RxPathways for details (844-989-7284)
Actualizado April 29, 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 4 de 4 — 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
  • MetroGel (metronidazole)
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 April 29, 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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