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Sankyo Pharma Open Care Program
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Sankyo Pharma Open Care Program
PO Box 8409
Somerville, NJ 08876
Phone
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(866) 268-7327 option #1
Fax:
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Eligibility
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The Sankyo Pharma Open Care Program is available to qualified patients with demonstrated medical and financial need. The program assists patients who are prescribed Sankyo products and are uncertain of their insurance coverage, and in locating alternative payment sources. Free product is provided to uninsured patients who qualify and for whom no alternative source of reimbursement can be identified. Patients must reside in the United States and have a U.S. treating physician. |
| Who Can Apply
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Anyone may call to initiate application process. |
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Required
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An original brand name prescription must be attached to application; also attach copy of most recent federal tax return and insurance documentation (i.e. insurance and/or Medicaid benefits and/or denial letter) at initial enrollment. These documents will be required at a later stage of patient's enrollment.
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Supply
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60 days. |
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Ship To
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Physician's office. |
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Note
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Both the patient and practitioner will be advised in writing of any denied requests. To continue medication coverage after the initial shipment, a new application must be filled out completely and sent to the address above with an original brand name prescription, written for a three-month supply of medication. Incomplete applications will be returned. Patient must call phone number above prior to mailing paperwork. |
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Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
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| Benicar Tablets |
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