866-730-5074

The patient cannot have prescription insurance, be ineligible for any federal or state programs and have an income at or below 200% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must be a US citizen or legal resident.  Patients who are eligible but did not enroll in Medicare Part D may still be eligible for this program. Differin Gel 0.3% is on the program, but not on the application.

Anyone can write the company to request an application. The application will be faxed out. The completed application can be faxed or mailed back.  The patient is notified of eligibility for the program. The estimated timeline for acceptance is 7-10 business days. 

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.

The patient is sent a pharmacy card. A copy of the same application with new dates is needed for refills. Once a year the application process must be repeated.

866-699-8239

 This program does not have income limitations. Medical diagnosis is not necessary This program is not valid in Massachusetts, so MA residents are not eligible. This is a copay assistance program that covers all or part of the applicant's copay for the medication. The amount of the copay assistance varies by medication, check the program's website for the exact amount. The application does not require a HCP signature, however the applicant must send the prescription(s) in with the application.

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 either faxed or mailed out upon request. The completed application can be faxed or mailed back.    

Not applicable.

The medication is sent to the patient's home.