Programas de asistencia al paciente para Spravato

Solicite apoyo para su receta con Spravato

Si califica, los programas a continuación le pueden ser útiles para conseguir Spravato. 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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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program

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

Provienen de: Johnson & Johnson Patient Assistance Foundation, Inc.
PO Box 42796 Cincinnati, OH 45242
TEL: 800-652-6227
FAX: 888-526-5168
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Spravato (esketamine)
Requisitos de Elegibilidad
  • Insurance Status Must have no prescription coverage for needed medication
  • Those with Part D Elibible? *See Additional Information Section Below
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medication must be for outpatient use only
  • U.S. Residency Required? The patient must also be permanently residing in the US or US territories.
Solicitud
  • Obtaining Call or download
  • Receiving Faxed, mailed or downloaded from website
  • 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 Not specified
  • Sent To Doctor's office or patient is sent card to be used at pharmacy
  • Delivery Time Varies
  • Refill Proces Varies per medication
  • Limit Varies
  • Re-application New application, new documentation yearly
Información Adicional
*Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. Please Contact the program for more information (1-800-652-6227). **Please call 1-800-652-6227 or visit Program website for specific FPL income requirements.
Actualizado July 15, 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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