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Benefix Patient Assistance Program
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5870 Trinity Parkway
Suite 600
Centerville, VA 20120
Phone
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888-999-2349
Ext OPT1, OPT2
Fax:
703-310-2524
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Eligibility
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The patient must have no insurance and have an income at or below $25,000 if single ($40,000 for a family). In cases of emergency, the company will send replacement after the medication was taken, but this is not normally a replacement program. |
| Who Can Apply
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The doctor/doctor's office should call for an application. |
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Required
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The doctor must fill out a section and sign the application.The patient must fill out a section and sign the application. |
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Supply
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Up to a 90-day supply |
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Ship To
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Doctor's office |
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Note
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The doctor/doctor's office should call for an application. |
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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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| BeneFix |
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