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Since Restasis ain't cheap, I thought this might help some people. I got this info from the Partnership for Prescription Assistance's website (www.pparx.org). On their website you select which medication you take and then you can see if there is an assistance program for it.
Allergan Patient Assistance Program
Company
Allergan
Contact Information
Allergan Patient Assistance Program
PO Box 4015
Clinton, NJ 08809
1-(800) 553-6783 (phone)
1-(908) 713-7736 (fax)
Physician requests should be directed to:
Allergan Patient Assistance Program
PO Box 4015
Clinton, NJ 08809
1-(800) 553-6783 (phone)
Product(s) covered by program:
Alphagan® P 0.15%
Lumigan® .03% Q.D.
Restasis® .15%
TAZORAC CREAM .05% ®
TAZORAC CREAM .1% ®
TAZORAC GEL .05% ®
TAZORAC GEL .1% ®
Resources:
Allergan Patient Assistance Program Application
Eligibility:
The objective of the Patient Assistance Program is to provide assistance to patients who are not eligible for Medicare Part D and are without another form of drug coverage and cannot afford their medications. Patients must reside in the United States and be under the care of a U.S. based physician and not be eligible for drug coverage by any private or public assistance program such as Medicare or Medicaid. Annual household income limits do apply but each case is reviewed on an individual basis.
Other Information:
Who Can Apply:
* Physician's office may apply on patient's behalf.
Required:
* Physician may complete the application on line sign & fax the request form attesting to need of the patient. Physician's state license or Optometrist's TPA number is required.
* Patient's signature is required as well as proof of income
Supply:
* 6 month supply; reorder after 5 months.
Ship To:
* Physician's Office, to be provided to the patient at the Physician's Office.
Note:
* Patient request forms must be filled out completely, signed by the Physician, and faxed or mailed in with appropriate proof of need. (see instruction page of the application)
Allergan Patient Assistance Program
Company
Allergan
Contact Information
Allergan Patient Assistance Program
PO Box 4015
Clinton, NJ 08809
1-(800) 553-6783 (phone)
1-(908) 713-7736 (fax)
Physician requests should be directed to:
Allergan Patient Assistance Program
PO Box 4015
Clinton, NJ 08809
1-(800) 553-6783 (phone)
Product(s) covered by program:
Alphagan® P 0.15%
Lumigan® .03% Q.D.
Restasis® .15%
TAZORAC CREAM .05% ®
TAZORAC CREAM .1% ®
TAZORAC GEL .05% ®
TAZORAC GEL .1% ®
Resources:
Allergan Patient Assistance Program Application
Eligibility:
The objective of the Patient Assistance Program is to provide assistance to patients who are not eligible for Medicare Part D and are without another form of drug coverage and cannot afford their medications. Patients must reside in the United States and be under the care of a U.S. based physician and not be eligible for drug coverage by any private or public assistance program such as Medicare or Medicaid. Annual household income limits do apply but each case is reviewed on an individual basis.
Other Information:
Who Can Apply:
* Physician's office may apply on patient's behalf.
Required:
* Physician may complete the application on line sign & fax the request form attesting to need of the patient. Physician's state license or Optometrist's TPA number is required.
* Patient's signature is required as well as proof of income
Supply:
* 6 month supply; reorder after 5 months.
Ship To:
* Physician's Office, to be provided to the patient at the Physician's Office.
Note:
* Patient request forms must be filled out completely, signed by the Physician, and faxed or mailed in with appropriate proof of need. (see instruction page of the application)
Turns out that when you buy Restasis through insurance and get one tray "free", you still get to pay 35$ (same co-pay as before) to get the second (aka, a month's supply).
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