Zomacton Patient Assistance Programs

Zomacton: Apply for prescription assistance below

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

ZomAccess Financial Support Patient Assistance Program

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

Provided by: Ferring Pharmaceuticals, Inc.
None
TEL: 844-944-9646
FAX: 844-402-1027
Languages Spoken:
English, Spanish
Program Website
Medications
  • Zomacton (somatropin (rDNA origin))
Eligibility Requirements
  • Insurance Status Must be uninsured or have a temporary lapse in insurance coverage.
  • Those with Part D Elibible? No
  • Income Varies
  • Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Application
  • Obtaining Call or download
  • Receiving Downloaded from website
  • Returning The completed application must be faxed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Within 24 hours
Medication
  • Amount/Supply Amount requested is sent
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Shipped overnight
  • Refill Proces Company contacts patient to arrange
  • Limit One calendar year
  • Re-application Must re-enroll at end of calendar year
Additional Information
This program also provides co-pay and reimbursement assistance.
Updated October 16, 2018

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