Programas de asistencia al paciente para Osmolex ER

Solicite apoyo para su receta con Osmolex ER

Si califica, los programas a continuación le pueden ser útiles para conseguir Osmolex ER. 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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AccessOsmolex

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

Provienen de: Osmotica Pharmaceuticals Corp. & Vertical Pharmaceuticals, LLC
None
TEL: 833-676-6539
FAX: 866-750-9516
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Osmolex ER (amantadine)
Requisitos de Elegibilidad
  • Insurance Status Contact program for details.
  • Those with Part D Elibible? Contact program for details.
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not disclosed
  • U.S. Residency Required? US residency requirements are not specified.
Solicitud
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application must be faxed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Contact program for details.
  • Limit Contact the program for details
  • Re-application Contact program for details.
Información Adicional
This program provides copay assistance.
Actualizado August 16, 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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Patient Access Network Foundation (PAN)

(Programa 2 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
  • Osmolex ER (amantadine)
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 August 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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