Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 2.
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Cancidas

HealthWell Foundation Copay Program

This is a copay assistance program

Provided by: HealthWell Foundation

PO Box 220410
Chantilly, VA 20153-0410

TEL: 800-675-8416


FAX: 800-282-7692
Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

 HealthWell Foundation Copay Program: Contact program

 

Medications

  • Cancidas (caspofungin)
 

Eligibility Requirements   

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must reside in the US
   

Application

Obtaining Call or complete online
Receiving Sent out or may be completed online
Returning Mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified in writing
Decision Timeframe 3-5 business days
   

Medication

Amount/Supply Not applicable
Sent To Varies
Delivery Time Not specified
Refill Process Good for one year
Limit Not specified
Re-application New application every 12 months
   

Additional Information

This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease.

Call for most recent medications as the list is subject to change.
Updated November 18, 2016


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 2.
 

Cancidas

Merck Product Replacement Patient Assistance Program

For Healthcare Professionals Only

Provided by: Merck & Co., Inc.

PO Box 8122
Somerville, NJ 08876

TEL: 866-840-5400


FAX: 877-923-6786
Languages Spoken:

English

Program Website

 

Program Applications and Forms

 Merck Product Replacement Patient Assistance Program: Contact Program

 

Medications

  • Cancidas injectable; iv (caspofungin)
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be residing in the US or a US territory, and under the care of a US physician
   

Application

Obtaining Doctor/Doctor's office must call
Receiving Not specified
Returning Not specified
Doctor's Action Doctor/Doctor's office must call
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Doctor notified
Decision Timeframe Not specified
   

Medication

Amount/Supply Varies
Sent To Doctor's office or specific site
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

Resources for HEALTHCARE PROFESSIONAL ONLY.

This program is designed to help indigent and uninsured patients.

Contact Merck Helps for more information: 1-866-840-5400

For ZERBAXA, please call 1-866-363-6379
Updated November 01, 2016