Hepsera Patient Assistance Programs

Hepsera: Apply for prescription assistance below

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

Advancing Access Program

(Program 1 of 2 — Scroll down to see them all )

Provided by: Gilead Sciences, Inc.
PO Box 13185 La Jolla, CA 92039-3185
TEL: 800-226-2056
FAX: 800-216-6857
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Hepsera (adefovir dipivoxil)
Eligibility Requirements
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Contact program for details.
  • Income Between 400-500% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must also be residing in the US.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed or mailed
  • Returning The completed application can be faxed or 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 and Doctor notified in writing
  • Decision Timeframe 3-5 business days
Medication
  • Amount/Supply Varies. *see below for details
  • Sent To Varies. *see below for details
  • Delivery Time 1-2 business days
  • Refill Proces Patient contacts pharmacy
  • Limit One calendar year
  • Re-application Once a year new application required. Financial documentation may be requested any time
Additional Information
Insurance benefits, claims assistance and/or other reimbursement help is offered. If the application is for Vistide, then prescription must be included because it will be sent to the doctor's office. The other medications are given using a pharmacy card. This program is for outpatient use only. This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs. IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company. This program also provides copay assistance.
Updated October 11, 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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Good Days Program

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

Provided by: Good Days from CDF
Attn: Enrollment 6900 Dallas Parkway Suite #200 Plano, TX 75024
TEL: 877-968-7233
FAX: 214-570-3621
Languages Spoken:
English
Program Website
Medications
  • Hepsera (adefovir dipivoxil)
Eligibility Requirements
  • Insurance Status Not specified
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? US residency requirements are not specified.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application can be faxed, mailed or submitted online.
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient and/or Doctor are notified
  • Decision Timeframe Varies
Medication
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Must re-enroll at end of calendar year
Additional Information
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.
Updated October 5, 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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