Programas de asistencia al paciente para Spiriva Respimat

Solicite apoyo para su receta con Spiriva Respimat

Si califica, los programas a continuación le pueden ser útiles para conseguir Spiriva Respimat. 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.

¿Está buscando otro tipo de medicamento?

Boehringer Ingelheim Cares Foundation Patient Assistance Program

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

Provienen de: Boehringer Ingelheim Cares Foundation, Inc.
PO Box 66745 St. Louis, MO 63166-6745
TEL: 800-556-8317
FAX: 866-851-2827
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Stiolto Respimat (tiotropium bromide/olodaterol)
Requisitos de Elegibilidad
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Yes, but contact program for details
  • Income Based on FPL
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? Must be a US resident
Solicitud
  • Obtaining Call or download
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application must be faxed or mailed from the doctor's office.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach proof of income and other requested documentation
  • Decision Communicated Patient notified in writing
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Up to 90 day supply
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Not specified
  • Refill Proces Patient or Doctor's office needs to contact company
  • Limit Not specified
  • Re-application New application yearly
Información Adicional
Some Medicare eligible patients who have difficulty meeting their Part D drug costs and who do not qualify for other assistance may be eligible. For Gilotrif, patient must not use this program's application. Please contact the BI Cares Foundation Gilotrif Patient Assistance Program at 877-814-3915. For Ofev, patient must not use this program's application. Please contact the BI Cares Foundation Gilotrif Patient Assistance Program at 888-304-8946.
Actualizado January 28, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

Volver al principio

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
  • Stiolto Respimat (tiotropium bromide/olodaterol)
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 Medically appropriate condition/diagnosis
  • 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 January 4, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

Volver al principio