Horizant Prescription Assistance Programs

Horizant: Apply for prescription assistance below

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

Arbor Patient Assistance Program

(Program 1 of 1 — 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
  • Horizant (gabapentin enacarbil)
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.
  • 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
  • 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 May 14, 2019

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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