Programas de asistencia al paciente para Ridaura

Solicite apoyo para su receta con Ridaura

Si califica, los programas a continuación le pueden ser útiles para conseguir Ridaura. 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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Sebela Patient Assistance Program (Lotronex & Ridaura)

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

Provienen de: Sebela Pharmaceuticals Inc.
PO Box 219 Gloucester, MA 01931
TEL: 866-562-7902
FAX: 888-246-6527
Idiomas hablados:
English
La Página del Programa
Medicamentos
  • Ridaura (auranofin)
Requisitos de Elegibilidad
  • Insurance Status *See Additional Information section below
  • Those with Part D Elibible? Determined case by case. *See Additional Information Section Below
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? Must be residing in the US or a US territory, and under the care of a US physician
Solicitud
  • Obtaining Call or download
  • Receiving Faxed, emailed, mailed or downloaded
  • Returning The completed application can be faxed, mailed or emailed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient notified by email or phone
  • Decision Timeframe 5-7 business days
Medicamento
  • Amount/Supply Contact the program for more details.
  • Sent To Doctor's office or patient's home
  • Delivery Time Once approved; shipped next business day
  • Refill Proces Patient or Doctor's office needs to contact company
  • Limit None
  • Re-application New prescription every 3 months. New application every 6 months.
Información Adicional
* Must not have Health insurance coverage (private or government) that pays for requested products and haven’t for at least three months. **Medicare Part D - Copy of insurance denial letter required. ***The manufacturer supporting this program does not charge for applying to the program nor for any products applicants receive. Applicants using the services of a commercial advocacy service may have to supply additional documentation. 
Actualizado December 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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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
  • Ridaura (auranofin)
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 November 22, 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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