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INOtherapy Assistance Program
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INOtherapy Assistance Program
PO Box 1968
Danbury, CT 06813-1968
Phone
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(877) 566-9466
Fax:
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Eligibility
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Eligibility is based on income and lack of precription coverage. Each application is reviewed individually to determine eligibility. |
| Who Can Apply
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Anyone may call to initiate application process. |
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Required
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A completed application, verification of diagnosis and patient's proof of income are required. |
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Supply
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Amount used. |
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Ship To
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Medication is credited to hospital's account. |
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Note
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This is a product replacement program. Negative decisions may be appealed. |
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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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| INOmax (nitric oxide) |
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