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I understand that the Patient Assistance Program has the right to modify or discontinue this program and its eligibility requirements or to terminate assistance at any time and without prior notice. Please return a copy of this signed form along with the completed Qualification application form to the Patient Assistance Program 2008 Duramed Pharmaceuticals Inc. PPAPPAD October 2008 Paraguard262088W 6/9/06 1 57 PM Page 1 FLAT SI.

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Novartis Patient Assistance Foundation provides medicines at no cost to eligible US patients who are experiencing financial hardship.

The Emergency Prescription Assistance Program, or EPAP, helps people in a federally-identified disaster area who do not have health insurance get the prescription drugs, vaccinations, medical supplies, and equipment that they need.

Savings (available through the Rexulti Savings Card): Eligible commercially insured patients pay as little as $0 per 30-day supply and save up to $100 per fill; valid for 12 prescriptions per year; for additional information contact the program at 844-415-0674.

The Prescription Drug Donation Program allows for certain prescription drugs that would normally be discarded to be donated to participating providers. Individuals who would normally be unable to get these medications can receive them from participating providers.

The Medication Assistance program provides resources to help those who do not have health insurance and limited or no prescription coverage obtain their prescription medication for free or almost free.

You get unlimited prescriptions through your Medicaid or CHIP coverage if you go to a pharmacy in Superior's network. There are some medications that may not be covered through Medicaid or CHIP. A pharmacy in the Superior network can let you know which medications are not covered.

With the Savings Card, you may pay as little as $4 for each 30-day fill of brand-name . Eligible patients could save up to $1,800 a year. Savings Card only works on brand-name . Terms and Conditions apply.

The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage to get the medicines they need for free or nearly free.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232