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Patient Assistance Information

 
1 Program for BeneFix
 
 
Benefix Patient Assistance Program

5870 Trinity Parkway
Suite 600
Centerville, VA 20120
Phone : 888-999-2349 Ext OPT1, OPT2
Fax: 703-310-2524
Eligibility
> 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
> The doctor/doctor's office should call for an application.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section and sign the application.
Supply
> Up to a 90-day supply
Ship To
> Doctor's office
Note
> The doctor/doctor's office should call for an application.
 
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.
 
BeneFix