| |
Keys2Care
|
Taro Pharmaceuticals U.S.A., Inc.
3 Skyline Dr.
Hawthorne, NY 10532
Phone
:
855-611-3401
Fax:
855-423-8304
|
|
Eligibility
|
| > |
Patients must be uninsured or underinsured. Patients can have Medicare Part D but should contact the program for details. Patients must be at or below 600% of the Federal Poverty Level and must be a US citizen or legal resident. |
| Who Can Apply
|
| > |
Patients or healthcare providers can call or download an application . |
|
Required
|
| > |
Doctors must complete a section and sign. Patients must complete a section, sign, and attach proof of income. |
|
Supply
|
| > |
30 day supply |
|
Ship To
|
| > |
Patient's home, unless otherwise noted |
|
Note
|
| > |
This program also provides copay assistance. |
| |
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.
|
| Keveyis tablet |
| |
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
|
| Download printable Form |
(Requires Acrobat Reader) 
|
| |
|
|