NeedyMeds

This program provides generic medications at a discount.

Xubex Patient Assistance Program

Provided by:

Xubex

PO Box 1244 Winter Park, Fl 32790-1244 TEL: 866-699-8239 ALT PHONE: 407-478-2663 FAX: 407-671-7960	Program Website

	Languages Spoken: English

Patient assistance
applications

Xubex Patient Assistance Program

Medications

Anucort-HC Suppository 25mg (hydrocortisone)

Eligibility Requirements

APPLICATION

MEDICATION

Insurance Status	May have insurance
Those with Part D Eligible?	Yes
Income	No limits
Diagnosis/Medical Criteria	Not specified
US Residency Required?	Yes

Obtaining	Call or download
Receiving	Faxed, mailed or downloaded from website
Returning	Mail or fax
Doctor's Action	Give prescription to patient
Applicant's Action	Complete section, sign
Decision Communicated	Not specified
Decision Timeframe	Not specified

Amount/Supply	Varies
Sent To	Doctor's office or patient's home
Delivery Time	Within 10 days
Refill Process	Automatically sent out
Limit	Varies per medication
Re-application	New application, new documentation yearly

Additional Information:

No proof of income is required. There are fees for the medications:$20-$45 for a 90 day supply. ($40 or $60 for a 180 day supply and $80 or $120 for a 360 day supply.) Check the website for the exact price. A shipping and ordering fee of $3.85 is charged for each order. Requests may be expedited by having the physician fax the completed form to the Xubex pharmacy.