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Program 1 of 4 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Pfizer, Inc.
Program Name Pfizer Connection to Care
Program Address PO Box 66585
St. Louis, MO 63166-6585
Phone Number

866-706-2400

Fax Number
Medications on Program Celebrex Capsules 100mg, 200mg, 400mg (celecoxib)
Application Forms Pfizer Connection to Care
Pfizer Connection to Care (Spanish)
On-line Application
No on-line application available at this time
Web Site Click to go to program's web site
Eligibility Guidelines and Notes

The patient must have no prescription coverage for any medications and and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must also reside in the US.  If a patient has insurance, including Medicare Part D,meets the income guidelines and has a prescription to a medication on this program and cannot afford the co-pay due to extreme medical or financial hardship, s/he may qualify to get assistance and should call the program. For Lyrica only: the prescription for Lyrica, as well as a copy of the patient's driver's license or other picture ID must be sent with the application. Please note, Lopid is on back order and will be added back to the program when it is available.

Application Process

Anyone requesting assistance can call the above number to request an application be mailed or faxed out or download it from the website. The application can be faxed, mailed out or downloaded from website. The completed application must be mailed back.  Both the patient and the health care professional are notified in writing of acceptance or denial.  Allow 4 weeks for processing and delivery of medication.

Application Requirements

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

Program Details

Up to a 90 day supply is sent to the doctor's office, except for Lyrica which is sent to the patient's home. The doctor can refill prescriptions or add new Pfizer medicines by calling 866-706-2400. Once a year a new application with financial documentation is needed.

Last Updated July 19, 2010


                                         

Program 2 of 4 Scroll down to see them all.

This is a discount card program.
Pharmaceutical Company Together Rx Access
Program Name Together Rx Access
Program Address PO Box 9426
Wilmington, DE 19809-9944
Phone Number

800-444-4106

Fax Number
Medications on Program Celebrex Capsules 100mg, 200mg, 400mg (celecoxib)
Application Forms Not Applicable
On-line Application
No on-line application available at this time
Web Site Click to go to program's web site
Eligibility Guidelines and Notes

The patient must have no prescription coverage for any medications and have an income at or below $45000 if single, $60000 for a family of 2, $75000 for a family of 3, $90000 for a family of 4, $105000 for a family of 5 Medical diagnosis necessary for this program is not specified.  The patient must not be eligible for Medicare. Most cardholders save between 25%-40% on brand name prescription medications. Each card holder's savings depend on such factors as the particular drug purchased, amount purchased, and the pharmacy where purchased.

Application Process

The patient can enroll online to get their ID number which can be used immediately.      

Application Requirements

Not applicable.

Program Details

The patient is sent a Together Rx Access prescription savings card.  

Last Updated May 10, 2010


                                         

Program 3 of 4 Scroll down to see them all.

This is a discount card program.
Pharmaceutical Company Pfizer, Inc.
Program Name Pfizer Pfriends
Program Address PO Box 66543
St Louis, MO 63133
Phone Number

866-706-2400

Fax Number
Medications on Program Celebrex Capsules 100mg, 200mg, 400mg (celecoxib)
Application Forms Pfizer Pfriends
Pfizer Pfriends (Spanish Application)
On-line Application
No on-line application available at this time
Web Site Click to go to program's web site
Eligibility Guidelines and Notes

The patient must have no prescription insurance. Not applicable Medical diagnosis necessary for this program is not specified. The patient must also reside in the US. This is not an income based program. It is a savings card program. Phone enrollments are accepted. For Lyrica only: the prescription for Lyrica, as well as a copy of the patient's driver's license or other picture ID must be sent with the application. Lopid is currently not available, but will be added back to the program when available.

Application Process

Anyone requesting assistance can call to request a faxed application or download it from the website. The application will be faxed out. The completed application must be mailed back.  The patient is notified in writing of acceptance or denial.  

Application Requirements

The doctor needs to provide a prescription to the patient. The patient must fill an application form. Renewal information will be sent to the patient prior to the end of the enrollment year.

Program Details

If accepted, the patient is sent a Pfizer Pfriends savings card that can be used at over 95% of pharmacies in the US. When filling their Pfizer prescription, accepted patients simply present the Pfizer Pfriends card to their pharmacist for immediate saving  Every year a new application is needed.

Last Updated August 12, 2010


                                         

Program 4 of 4.

This company does not offer a patient assistance program.
Pharmaceutical Company HealthWell Foundation
Program Name HealthWell Foundation Copay Program
Program Address P.O Box 4133
Gaithersburg, MD 20878
Phone Number

800-675-8416

Fax Number 800-282-7692
Medications on Program Celebrex Capsules 100mg, 200mg, 400mg (celecoxib)
Application Forms Not Applicable
On-line Application
No on-line application available at this time
Web Site Click to go to program's web site
Eligibility Guidelines and Notes

Applicants with insurance are eligible. The Foundation considers an individual's financial, medical, and insurance situation when determining who is eligible for assistance. Families with incomes below 400% of the Federal Poverty Level may qualify. Cost of living in a particular city or state is also taken into account. Medication must be used for medically appropriate condition. The patient must also reside in the US. 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.

Application Process

Anyone can call to get the application sent out or it may be completed online. The application is sent out or it may be completed online.     

Application Requirements

Not applicable.

Program Details

Not applicable.

Last Updated April 28, 2010