Program

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Program 1 of 2 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company	Schering Plough Corporation
Program Name	Schering-Plough Cares
Program Address	PO Box 52122 Phoenix, AZ 85072
Phone Number	800-656-9485opt3
Fax Number	800-995-9620
Medications on Program	Cipro Oral Solution 250mg, 500mg (ciprofloxacin) Cipro Tablets 250mg, 500mg (ciprofloxacin)
Application Forms	Schering-Plough Cares
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 the requested medication and have an income at or below 250% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. Patients who have Medicare Part D, or were eligible for Part D but did not enroll may still be eligible for this program, but need to go through the following steps. First apply and be denied to this program, then send that denial letter with a denial letter from the Low Income Subsidy Program and proof that the patient has spent 3% of their household income out of pocket to purchase their prescription medications this year. Patients currently on Medicare Part D may also be eligible and need gather some of the same documentation. Call the company for specific details.
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 can be faxed or mailed back. Both the patient and doctor are notified in writing of acceptance or denial.
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. The doctor/doctor's office must fill out a replacement form to get refills. Once a year a new application with financial documentation is needed.
Last Updated	October 27, 2009

Program 2 of 2.

This program provides generic medications at a discount.
Pharmaceutical Company	Xubex Pharmaceuticals
Program Name	Xubex Patient Assistance Program
Program Address	PO Box 1244 Winter Park, Fl 32790-1244
Phone Number	866-699-8239
Fax Number	407-671-7960
Medications on Program	ciprofloxacin Tablets 250mg, 500mg, 750mg (Cipro)
Application Forms	Xubex Pharmaceutical Services
On-line Application	Link to online application
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	Applicants with insurance are eligible. The patient must have an income at or below 243% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. This is a program for generic medications only. There are fee for the medications either $20 or $30 for a 90 day supply. ($40 or $60 for a 180 day supply and $80 or $120 for a 360 day supply.)Xubex now offers a 30 day supply of some medications free of charge. Patients may apply online or print the prescription, complete and fax to the Xubex pharmacy for processing. Requests may be expedited by having the physician fax the completed form to the Xubex pharmacy.
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 can be faxed or mailed back. The medication is shipped within 10 business days.
Application Requirements	The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.
Program Details	The medication is sent to either the doctor's office or the patient's home. The company automatically sends out refills. Once a year a new application with financial documentation is needed.
Last Updated	August 14, 2009