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Core Connections Program
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4500 Progress Blvd.
Louisville, KY 40218
Phone
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855-336-3322
Fax:
800-481-3325
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Eligibility
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The Core Connections Program provides brand name medications at no or low cost. Patient that have insurance are eligible. Patients must be at or below 250% of the federal poverty level. They must also have an FDA-approved diagnosis and be a US citizen or legal resident. |
| Who Can Apply
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Patients and doctors can call or download the application from the link below. |
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Required
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The application must be completed and signed by the doctor and the patient. It must be faxed from the doctor's office along with required documentation. A new application is needed yearly. |
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Supply
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Up to 1 month supply |
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Ship To
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Patient's home, unless otherwise noted. |
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Note
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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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| Rasuvo injection |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
| Download printable Form |
(Requires Acrobat Reader) 
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