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Patient Assistance Information

 
 
 
Menomune Patient Assistance Program

Menomune Patient Assistance Program
C/O NORD
Danbury, CT 06813-1968
Phone : 877-798-8716
Fax: 203-798-2964
Eligibility
> The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. The patient is given assistance from 25%-100% for one year. A negative decision can be appealed.The patient must also be a US resident.
Who Can Apply
> Anyone with the patient's and the doctor's information can call.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section, sign the application and attach proof of income and any insurance information.
Supply
>
Ship To
> Doctor's office
Note
> Anyone with the patient's and the doctor's information can call.
 
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.
 
Menomune A/C/Y/W-135 (meningococcal polysaccharide vaccine)