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Reset FieldsAzilect Patient Assistance Program P.O. Box 139 Somerville, NJ 08876 Phone: (866) 217-7163 / Fax: (866) 838-5832 FORM for Patient Assistance Program (PAP) Patient Information Name.

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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.

Many states offer State Pharmaceutical Assistance Programs (SPAPs) to help residents pay for prescription drugs. Each program works differently. States may coordinate their drug assistance programs with Medicare's prescription drug benefit (Part D).

The Virginia HIV SPAP office may be reached by phone at 855-362-0658.

Pharmaceutical manufacturers may sponsor patient assistance programs (PAPs) that provide financial assistance or drug free product (through in-kind product donations) to low income individuals to augment any existing prescription drug coverage.

What are SPAPs? State Pharmaceutical Assistance Programs (SPAPs) are state-run programs that assist low-income seniors and adults with disabilities in paying for their prescription drugs.

Virginia Medication Assistance Program (VA MAP)

Community health centers may offer prescription assistance to low-income patients. To locate a center in your area, contact the Health Resources and Services Administration at 888-ASK-HRSA (888-275-4772). Local Area Agencies on Aging may be able to assist patients who are 65 or older and can't afford their medications.

Eligibility Guidelines Be a Connecticut resident for 6 months prior to application. Be 65 years of age or older. Cannot be on Medicaid. Must be on or sign up for a Medicare Part D plan.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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