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MS Lifelines
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Phone
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(877)447-3243
Fax:
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Eligibility
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Insurance requirements determined case by case. Medicare part D eligibility varies. Income requirements for this program have not been disclosed. Must be a US resident. |
| Who Can Apply
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Applicant must call for prescreening and application will be sent to the Patient via mail. Patient will be notified of decision within 7-10 business days. |
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Required
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Must have MS. Doctor must fax in prescription. Patient must complete application, sign, attach proof of income and other requested documentation. |
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Supply
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Amount/supply varies. Company contacts Patient to arrange refills. Refill limit not specified. New application and documentation required yearly. |
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Ship To
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Medication will be shipped to Patient's home once approved. Shipped same day. |
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Note
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Program does not use financial guidelines or an application for the first year of enrollment. They encourage patients to call the toll free number for assistance.
Eligibility determined on a case-by-case basis. |
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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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| Rebif syringe; subcutaneous |
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