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What We Do For You

1. Determine if your brand name medicine has a free medicine program.
2. Complete all the paperwork and get a signed prescription from your doctor.
3. Contact the drug companies on your behalf to explain your situation and ask for assistance.
4. Keep you up to date on the status of your prescription drugs.
5. Continue to work with the pharmaceutical companies and your doctor so that you will continue to receive your brand name medicine at no cost.

General Qualification Guidelines

1. Annual gross income must be less than outlined below.
2. You must not have insurance coverage that pays for your medicine.
3. You must be able to communicate with us via email or telephone.
4. You must be a legal US citizen or resident.

2010 Income Guidelines
Size of family unit	Total Household Income
1	$21,660
2	$29,140
3	$36,620
4	$44,100
5	$51,580
6	$59,060
7	$66,540
8	$74,020

How the Patient Assistance Program Works

1. There is a one- time enrollment fee of $125.00 and then a low monthly service fee of $55.00 per month regardless of the number of brand name medicines we help you with!
2. A personal advocate will contact you to review our program and answer any questions you may have.
3. We work with your physician and the drug companies to get you approved.
4. Generally your medicine should arrive in 3-4 weeks.

Our Guarantee to You

Although we cannot guarantee your approval, we will be diligent in our efforts to assist you.  If we can’t help you, you will never pay a fee. If you have family or friends who may benefit from this program, please let them know about us – you might be saving a life!

Thank you for choosing HelpForPrescription.com!