Programas de asistencia al paciente para Zinplava

Solicite apoyo para su receta con Zinplava

Si califica, los programas a continuación le pueden ser útiles para conseguir Zinplava. 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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Merck Connect

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

Provienen de: Merck & Co., Inc.
None
TEL: 800-489-5119
Idiomas hablados:
English
La Página del Programa
Solicitudes y Formularios
Medicamentos
  • Zinplava (bezlotoxumab)
Requisitos de Elegibilidad
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Determined case by case
  • Income Not disclosed
  • Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Solicitud
  • Obtaining Enroll online
  • Receiving Not specified
  • Returning The completed application's destination is not specified
  • Doctor's Action Enroll in the program
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Up to 30 day supply
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Información Adicional
Resources for HEALTHCARE PROFESSIONALS ONLY. The Physician must register to access tools and materials for patient support, product sample requests, up-to-date professional resources, and other Merck professional sites.
Actualizado March 18, 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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Merck Access Program for Zinplava

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

Provienen de: Merck Patient Assistance, Inc.
Merck Access Program PO Box 29067 Phoenix, AZ 85038
TEL: 877-709-4455
FAX: 800-977-1957
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Zinplava (bezlotoxumab)
Requisitos de Elegibilidad
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Contact program for details.
  • Income Not disclosed
  • 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 or downloaded from website
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Not specified
  • Sent To Doctor's office or specific site
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application New application yearly
Información Adicional
Patient must sign the enrollment form to give the program permission to access their financial information in order to determine eligibility. Patients in need who appear not to qualify should still call.
Actualizado March 18, 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