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MyPraluent
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MyPRALUENT
1670 Century Center Parkway Memphis, TN 38134
Phone
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844-772-5836
Ext 1
Fax:
844-872-5447
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Eligibility
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Patients must be uninsured or underinsured. Income requirements for this program have not been disclosed. Patients must have a medically appropriate condition/diagnosis and must reside in the US, Puerto Rico or the USVI. |
Who Can Apply
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Patients or healthcare providers can call to have an application faxed to the doctor's office or they can download one. |
Required
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Patients and doctors must each complete a section and sign the application. The application must then be faxed from the doctor's office. |
Supply
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As prescribed by Doctor |
Ship To
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Patient's home |
Note
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Insurance benefits, claims assistance and/or other reimbursement help is offered.
This program also provides copay assistance.
Additional resources available, including a puncture-resistant sharps disposal container and a PRALUENT Travel Kit. |
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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. |
Praluent disposal container |
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Printable Application Forms Applications that patients can fill out and bring to their doctor. |
Download printable Form |
(Requires Acrobat Reader)
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