Glucagen Hypokit Patient Assistance Programs

Glucagen Hypokit: Apply for prescription assistance below

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

Novo Nordisk Patient Assistance Program

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

Provided by: Novo Nordisk Pharmaceuticals, Inc.
PO Box 370 Somerville, NJ 08876
TEL: 866-310-7549
ALT PHONE: 866-310-7549
FAX: 866-441-4190
Languages Spoken:
English, Spanish
Program Website
Medications
  • GlucaGen Hypokit (glucagon)
Eligibility Requirements
  • Insurance Status Must be uninsured
  • Those with Part D Elibible? Contact program for details.
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
Application
  • 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 required documents
  • Decision Communicated Medications sent if accepted. If denied patient and doctor notified
  • Decision Timeframe 7-10 business days
Medication
  • Amount/Supply Up to 120 day supply
  • Sent To Doctor's office
  • Delivery Time Within 2 business days
  • Refill Proces Reorder form needs to be submitted
  • Limit Not specified
  • Re-application New application, new documentation yearly
Additional Information
This program also provides copay assistance.
Updated October 31, 2018

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

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