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Thiola Total Care Hub Program
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Phone
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844-484-4652
Fax:
877-473-3167
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Eligibility
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Insurance eligibility will be considered on a case by case basis. Income and residency requirements for this program have not been disclosed. The medication must be medically necessary as determined by a doctor. |
| Who Can Apply
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Patients or healthcare providers can download the application. |
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Required
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Doctors must complete a section, sign, and attach required documents. Providers must complete a section, sign, and attach required documents. The application must be faxed from the doctor's office. |
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Supply
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Varies |
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Ship To
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Doctor's office or patient's home |
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Note
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Co-payment assistance, reimbursement support, and patient assistance programs are available for eligible patients. |
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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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| Thiola (tiopronin) |
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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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