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Stelara Co-Pay Support Instant Savings Program
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14001 Weston Parkway, Suite 103
Cary, NC 27513
Phone
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888-222-3771
Fax:
877-234-3048
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Eligibility
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The Stelara Co-Pay Support Instant Savings Program is a copay assistance program and is intended for patients that are commercially insured. No income requirements have been specified. Patients must be a resident of the US or Puerto Rico. |
| Who Can Apply
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Patients or doctors can call or complete the application online. |
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Required
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Applications must be completed and signed by both the physician and patient and be faxed or mailed. |
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Supply
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Not specified. This program is good for one year. |
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Ship To
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Note
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This program also provides copay assistance. |
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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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| Remicade (infliximab) |
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RemiStart Patient Rebate Program and Extended Access Program
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14001 Weston Parkway, Suite 103
Cary, NC 27513
Phone
:
888-222-3771
Fax:
877-234-3048
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Eligibility
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The RemiStart Patient Rebate Program and Extended Access Program is intended for patients that are commercially insured. Income requirements for this program have not been disclosed. Patients must be a resident of the US or Puerto Rico. This medication must be prescribed for an on-label diagnosis. |
| Who Can Apply
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Patients can obtain an application by calling, printing from the link below or by asking their doctor for one. |
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Required
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Application must be completed and signed by the doctor and the patient. Patient and/or doctor will be notified of a decision. |
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Supply
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Not specified. |
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Ship To
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Note
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This program also provides copay assistance. |
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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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| Remicade (infliximab) |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
(Requires Acrobat Reader) 
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SimponiOne Cost Support-Safe Returns
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,
Phone
:
877-697-4676
Fax:
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Eligibility
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Patients must reside in the US, Puerto Rico or the US Virgin Islands. |
| Who Can Apply
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Patients can call or enroll online. |
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Required
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Patients can call or enroll online. |
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Supply
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1 kit |
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Ship To
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Shipped to patient's home. Patient must contact the company for refills. |
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Note
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Patient enrolls to receive a free container. |
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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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| Simponi Container disposal container |
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