Erythromycin Patient Assistance Programs

Erythromycin: Apply for prescription assistance below

If you are eligible, the programs below can help you afford erythromycin. 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?

HealthWell Foundation Copay Program

(Program 1 of 7 — Scroll down to see them all)

Provided by: HealthWell Foundation
PO Box 220410 Chantilly, VA 20153-0410
TEL: 800-675-8416
FAX: 800-282-7692
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • None (erythromycin)
Eligibility Requirements
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income Varies
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must also be residing in the US.
Application
  • Obtaining Call or complete online
  • Receiving Sent out or may be completed online
  • Returning The completed application must be 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 notified in writing
  • Decision Timeframe 3-5 business days
Medication
  • Amount/Supply Not applicable
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Good for one year
  • Limit Not specified
  • Re-application New application every 12 months
Additional Information
This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease. Call for most recent medications as the list is subject to change.
Updated September 24, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 2 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 3 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 4 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 5 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 6 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top

Arbor Patient Assistance Program

(Program 7 of 7 — Scroll down to see them all)

Provided by: Arbor Pharmaceuticals, LLC.
PO Box 6123 Lawrenceville, NJ 08648
TEL: 844-884-8700
FAX: 844-287-5417
Languages Spoken:
English Others By Translation Service
Program Website
Medications
  • PCE (erythromycin)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? No
  • Income Varies. **See below for details
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or permanent resident.
Application
  • Obtaining Call or download
  • Receiving Mailed
  • 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 Patient and Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 48 hours
  • Refill Proces Patient must contact company
  • Limit Maximum of 3 refills through 12/31 of current calendar year
  • Re-application New application yearly
Additional Information
Must be at or below 300% FPL for BiDil. Must be at or below 200% FPL for all other medications. Call for most recent medications as the list is subject to change. This program also provides copay assistance.
Updated September 17, 2018

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for erythromycin prices here.

Back to top