800-424-3727

800-292-6363

The patient can have no public or private prescription insurance and have an income at or below $30,000 for an individual; $40,000 for a couple; $50,000 for a family of three; $60,000 for a family of four. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident, green card or work visa holder. Patients who are eligible for Medicare Part D but have not enrolled may still be eligible for this program. Individuals with Medicare Part D should apply to the AZ&ME Prescription Savings Program for people with Medicare Part D. The application for this program and the AstraZeneca Cancer Support Network Patient Assistance Program is the same and says 'Application for Free AstraZeneca Medicines' on the upper left side. People who are in Medicare and may be eligible for the Limited Income Subsidy can apply. However, if they are accepted into the LIS, they are no longer eligible for the AZ& ME Prescription Savings Program. This program has expanded the eligibility for assistance for qualifying patients who have lost their jobs, prescription drug coverage, had a change in income or household size.

Anyone requesting assistance can call to request a mailed application or download it from the website.  The completed application can be faxed or mailed back.  If the patient is denied, both patient and doctor are notified.  Once approved medicines are shipped out with in 5-7 business days.

The doctor needs to provide a prescription to the patient. The patient must fill out a section, sign the application and attach proof of income.

Up to a 90-day supply is sent to the doctor's office or the patient's home. The patient or doctor must contact the company for refills. The patient must reapply once a year.

800-292-6363

800-957-6285

Applicants with insurance are eligible. have an income less than or equal to $30,000 for an individual (less than or equal to $40,000 for a couple.) Medical diagnosis necessary for this program is not specified. The patient must also be a US resident, green card or work visa holder. The applicant must have spent at least 3% of the annual household income on prescription drugs this year. Applicant may print out a membership card to be shown at the pharmacy and one is also sent. Depending on income, one will pay between $15-25 for a 30 day supply of medication, $22.50-37.50 for a 60 day supply and $30-50 for a 90 day supply.

Not applicable.

Not applicable.

The medication can be picked up by the patient at the pharmacy.