Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Pathway Reimbursement Support Patient Assistance Program

Provided by: Abbott Nutrition

Abbott Nutrition Patient Assistance Program
PO Box 4280
Gaithersburg, MD 20885-4280

TEL: 800-558-7677


ALT PHONE: 866-801-5657
FAX: 866-734-7353
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Pathway Reimbursement Support Patient Assistance Program Application: Contact program

 

Brand Name Medications Covered

 
  • Calcilo XD
  • PediaSure Peptide
  • Cyclinex
  • PediaSure w/Fiber
  • EleCare
  • Perative
  • EleCare Jr.
  • Phenex
  • Ensure Original
  • Pivot 1.5 cal
  • Ensure Plus
  • Pro-Phree
  • Glucerna 1.2
  • Promote
  • Glucerna Shake
  • Promote with Fiber
  • Glutarex
  • Propimex
  • Hi-Cal
  • ProViMin
  • Hominex
  • Pulmocare
  • I-Valex
  • RCF (Ross Carbohydrate Free)
  • Jevity 1.2 Cal
  • Suplena
  • Ketonex
  • TwoCal
  • Nepro with Carb Steady
  • Tyrex
  • Osmolite 1.2 cal
  • Vital 1.5 cal
  • PediaSure
  • Vital AF 1.2 cal
  • PediaSure 1.5 cal
  • Vital High Protein
  • PediaSure Enteral Formula w-Fiber
 

Generic Name

 
  • medical drink
  • nutritional supplement
  • medical food
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria *See Additional Information section below
US Residency Required? Must reside in the US or the District of Columbia
   

Application

Obtaining Call or download from Programs website
Receiving Faxed or downloaded from website
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Varies
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

*Patient must require 100% of their caloric needs from the requested product.

A product specific request form must be submitted prior to acceptance. Contact Program for details.


Updated April 28, 2017