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Patient Assistance Information

 
1 Program for Isentress oral suspension; granule
 
 
SUPPORT Program for Isentress

SUPPORT Program
PO Box 305
San Bruno, CA 94066
Phone : 800-850-3430
Fax: 866-410-1913
Eligibility
> This program provides brand name medications at no or low cost to patients. Patients with insurance are eligible and Medicare Part D recipients will be considered on an exception basis. Patients must be at or below 500% of the federal poverty level. They must also live in the US and have a prescription from a US licensed doctor.
Who Can Apply
> Anyone interested in the program can call or download an application.
Required
> Doctors and Patients must complete and sign their portions of the application and it can returned by mail.
Supply
> Varies
Ship To
> Doctor's office or patient's home
Note
> nsurance benefits, claims assistance and/or other reimbursement help is offered. Exceptions to guidelines considered. This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs. IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company.
 
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.
 
Isentress oral suspension; granule
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
(Requires Acrobat Reader