Emverm Patient Assistance Programs

Emverm: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Emverm. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Impax Patient Assistance Program

(Program 1 of 1 — Scroll down to see them all )

Provided by: Impax Laboratories, Inc.
Impax Specialty Pharma Patient Assistance Program PO Box 66554 St. Louis, MO 63166-6554
TEL: 877-764-9021
FAX: 877-764-9022
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Emverm (mebendazole)
Eligibility Requirements
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Determined case by case
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? The applicant must have a social security number.
Application
  • Obtaining Call or download
  • Receiving Faxed 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 required documents
  • Decision Communicated Patient and Doctor notified in writing
  • Decision Timeframe 2-3 business days
Medication
  • Amount/Supply Amount requested is sent
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Within 5-7 business days
  • Refill Proces Good for 12 months
  • Limit Up to one year
  • Re-application Company contacts patient about reapplying
Additional Information
Those with Medicare Part D must have spent at least 3% of annual household income out-of-pocket on prescription medicines.
Updated October 19, 2018

Back to top