Malarone Pedatric Tablets, of program GlaxoSmithKline Bridges To Access,
A Free Prescription Drug Program of GlaxoSmithKline
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Malarone Pedatric Tablets of program GlaxoSmithKline Bridges To Access can be found below. The program GlaxoSmithKline Bridges To Access directed by GlaxoSmithKline conveys this drug Malarone Pedatric Tablets to patients who qualify after acceptance occurs. Read the available info and then proceed towards applying to the GlaxoSmithKline Bridges To Access program(s) for Malarone Pedatric Tablets by following their instructions. You may use the below directions as a general guide but rely on instructions given directly from the GlaxoSmithKline Bridges To Access program to get Malarone Pedatric Tablets meds. At times, a program's process may change without advanced notice.
Listen to the GlaxoSmithKline Bridges To Access program associate's requests competely because they are there to help you. No-cost prescription drug programs (this Malarone Pedatric Tablets prescription and others) exist for the good of everyone including needy patients, the program's company GlaxoSmithKline and even those who do not require this offer. The respect and good manner you show the program and its employees will help yourself and other patients for years into the future.
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Malarone Pedatric Tablets |
| Name of Program |
GlaxoSmithKline Bridges To Access |
| Affiliated Company |
GlaxoSmithKline |
| Address of Program |
PO Box 29129 |
| Address 2 |
Phoenix, Az 85129 |
| Address 3 |
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| Phone (Voice) |
866-728-4459 |
| Fax |
800-750-9923 |
| How to get application |
call program |
| General guidelines/directives for applicants |
US residency required and Multiple income household not more than 250% of the federal poverty level (Not more than $25,000 for single income household). Must not have prescription insurance. Program requests an 'Advocate' be contact person for patient during entire process. Advocate may be any healthcare worker involved in patient's care. (e.g. Physician, nurse, social worker,etc. satisfy requirements) |
| Beginning course of action to obtain drugs |
Advocate calls for an application to be faxed or mailed with patient ID number (Enrollment process may instead be started online at bridgestoaccess.gsk.com). Once application completed, advocate calls program to start enrollment process. If accepted during phone call enrollment, coupon attached to form is activated for 60 day supply of medication with small co-pay. Completed application must also be mailed to program. |
| Doctor/provider's |
Completes and signs application, attaches prescription for three 90 day refills. Advocate completes application section and signs form. |
| Responsibilities of Patient |
Completes detailed section on financial and income information. Provides documented proof of income and insurance information. |
| Distribution manner |
After initial 60 day supply, program ships medication to patient's home, however, Relenza, Dexedrine, and Lotronex must be picked up at a pharmacy. |
| Amount distributed |
After initial supply, program allows subsequent meds in a 90 day supply. |
| Refill process |
Patient calls 1-866-PATIENT to get 90 day refill. After six months, advocate will receive a form to reauthorize patient for another six months. Program sends re-enrollment form to advocate after one year to re-enroll the patient for subsequent year. |
| Program limitations |
Indefinite |
Paid source(s):
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