Lotrisone Patient Assistance Programs

Lotrisone: Apply for prescription assistance below

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

Merck Patient Assistance Program

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

Provided by: Merck Patient Assistance, Inc.
PO Box 690 Horsham, PA 19044-9979
TEL: 800-727-5400
Languages Spoken:
English, Spanish
Program Website
Medications
  • Lotrisone (clotrimazole/betamethasone)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Contact program for details.
  • Income At or below 400% of FPL
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? Must be residing in the US or a US territory, and under the care of a US physician
Application
  • Obtaining Call or download
  • Receiving Sent to doctor or patient
  • Returning Mail original application. Do not fax
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section and sign
  • Decision Communicated Call for decision
  • Decision Timeframe Up to 10 business days
Medication
  • Amount/Supply 90 day supply with up to 3 refills, for a total of up to 1 year of medications
  • Sent To Doctor's office or patient's home
  • Delivery Time Not specified
  • Refill Proces Patient requests refills via a toll-free number
  • Limit Not specified
  • Re-application New application yearly
Additional Information
At Merck we realize that sometimes exceptions need to be made based on the patient's individual circumstances. Individuals who do not meet the insurance criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial hardship, and their income meets the program criteria. *The Enrollment Form must be mailed. Please do not fax.
Updated November 8, 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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Rx Outreach Medications

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

Provided by: Rx Outreach
PO Box 66536 St. Louis, MO 63166-6536
TEL: 888-796-1234
FAX: 800-875-6591
Languages Spoken:
English, Spanish
Program Website
Medications
  • Lotrisone (clotrimazole/betamethasone)
Eligibility Requirements
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria Not required
  • U.S. Residency Required? The patient must also be residing in the US.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning Fax or E-Prescribe online
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section and sign
  • Decision Communicated Medications sent if accepted. If denied patient and doctor notified
  • Decision Timeframe Usually same day
Medication
  • Amount/Supply Varies
  • Sent To Doctor's office or patient's home
  • Delivery Time Not specified
  • Refill Proces Company contacts patient to arrange
  • Limit Only limited by manufacturer's guidelines
  • Re-application New application yearly
Additional Information
Some medications are available for a fee of $20 for up to a 180 day supply. Check the Rx Outreach website for the exact price and most current medication list. Contact Program for Spanish Application(s)/Form(s).
Updated September 10, 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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