Qnasl Patient Assistance Programs

Qnasl: Apply for prescription assistance below

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

TEVACares Foundation Patient Assistance Program

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

Provided by: TEVA Pharmaceuticals
PO Box 52028 Phoenix, AZ 85072
TEL: 877-237-4881
FAX: 877-438-4404
Languages Spoken:
English, Others By Translation Service
Program Website
Program Applications and Forms
Medications
  • QNASL aerosol; nasal (beclomethasone dipropionate aerosol; nasal)
Eligibility Requirements
  • Insurance Status Must have no prescription coverage
  • Those with Part D Elibible? No
  • Income Based on FPL
  • Diagnosis/Medical Criteria Not required
  • U.S. Residency Required? Must permanently reside in the US and be under the direct care of a US Physician
Application
  • Obtaining Call or download
  • Receiving Faxed, mailed or downloaded from website
  • 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 5-7 business days
Medication
  • Amount/Supply Varies
  • Sent To Doctor's office or patient's home
  • Delivery Time Within 5-7 business days
  • Refill Proces Reorder form needs to be submitted
  • Limit Varies per medication
  • Re-application New application yearly
Additional Information
The CephalonCares Foundation Patient Assistance Program for Fentora, Gabitril, Nuvigil and Tev-Tropin and the TEVA Assistance Program are now known as the TEVA Cares Foundation Patient Assistance Program. Call for most recent medications as the list is subject to change.
Updated July 16, 2018

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

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