Programas de asistencia al paciente para Pulmozyme

Solicite apoyo para su receta con Pulmozyme

Si califica, los programas a continuación le pueden ser útiles para conseguir Pulmozyme. 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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HealthWell Foundation Copay Program

(Programa 1 de 3 — 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
  • Pulmozyme (dornase alfa)
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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Genentech Access Solutions (Pulmozyme)

(Programa 2 de 3 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Genentech USA, Inc.
1 DNA Way, Mail Stop #858a South San Francisco, CA 94080-4990
TEL: 800-690-3023
ALT PHONE: 800-690-3023
FAX: 800-963-1792
Idiomas hablados:
English, Spanish
La Página del Programa
Medicamentos
  • Pulmozyme (dornase alfa)
Requisitos de Elegibilidad
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Determined case by case
  • Income Based on FPL
  • Diagnosis/Medical Criteria Varies
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Solicitud
  • Obtaining Call, download or apply online
  • Receiving Faxed, emailed, mailed or downloaded
  • Returning Fax, mail or submit online (Note: faxed prescriptions are only valid if faxed directly from a prescriber's office)
  • Doctor's Action Will be discussed with patient and Doctor after request is received
  • Applicant's Action Patient or patient representative signs authorization form
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Varies
Medicamento
  • Amount/Supply Varies
  • Sent To Varies
  • Delivery Time Contact Program for Details
  • Refill Proces Doctor/Doctor's office must contact company
  • Limit One year
  • Re-application Contact program for details.
Información Adicional
None
Actualizado June 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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Genentech Patient Foundation

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

Provienen de: Genentech USA, Inc.
None
TEL: 888-941-3331
FAX: 833-999-4363
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Pulmozyme (dornase alfa)
Requisitos de Elegibilidad
  • Insurance Status Uninsured or Underinsured with no prescription coverage for needed medication
  • Those with Part D Elibible? Contact program for details.
  • Income Income Guidelines published on Program Website
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Solicitud
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section and sign
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Varies
Medicamento
  • Amount/Supply Amount requested is sent
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Varies
  • Refill Proces Varies per medication
  • Limit Not specified
  • Re-application Not specified
Información Adicional
The Genentech Access to Care Foundation is now the Genentech Patient Foundation. Eligibility determined on a case-by-case basis. Call for most recent medications as the list is subject to change.
Actualizado June 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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