Hycofenix Patient Assistance Programs

Hycofenix: Apply for prescription assistance below

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

Mission Product Request

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

Provided by: Mission Pharmacal Company
TEL: 877-425-0325
ALT PHONE: 877-425-0325
FAX: 877-426-2795
Languages Spoken:
Program Website
Program Applications and Forms
  • Hycofenix solution (hydrocodone bitartrate/pseudoephedtine/guaifensesin solution)
Eligibility Requirements
  • Insurance Status Not specified
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not disclosed
  • U.S. Residency Required? US residency requirements are not specified.
  • Obtaining The Doctor should call for an application or download it from the website
  • Receiving Faxed to Doctor's office
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Complete section and sign
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Doctor notified
  • Decision Timeframe Not specified
  • Amount/Supply Varies
  • Sent To Doctor's office
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Doctor contacts company
Additional Information
Resources for HEALTHCARE PROFESSIONAL ONLY. The Doctor must contact the program to place an order.
Updated September 7, 2018

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

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