Don't qualify for this program?
Visit the DBAs to look for financial assistance based on your diagnosis.
Program 1 of 2.
Scroll down to see them all.		 Updated March 04, 2014
Diflucan

Rx Outreach Medications

This program provides both brand name and generic medications at no or low cost.

Provided by: Rx Outreach

PO Box 66536
St Louis, MO 63166-6536

TEL: 888-796-1234


ALT PHONE: 888-RXO-1234
FAX: 800-875-6591 		Languages Spoken:

English, Spanish

Program Website
 

Patient Assistance Applications

Rx Outreach Application

Rx Outreach Diabetic Supplies

Rx Outreach Medication List

Rx Outreach Refills and New Prescriptions Order Form
 

Medications
  • Diflucan Tablet 100mg, 200mg (fluconazole)
 

Eligibility Requirements
Insurance Status May have insurance
Those with Part D Eligible? Yes
Income At or below 300% of FPL
Diagnosis/Medical Criteria Not required
US Residency Required? Must reside in the US
   

Application
Obtaining Call, download or apply online
Receiving Faxed or mailed
Returning Fax or E-Prescribe online
Doctor's Action Give prescription to patient
Applicant's Action Complete section, sign
Decision Communicated Medications sent if accepted. If denied patient and Doctor notified
Decision Timeframe Usually same day
   

Medication
Amount/Supply Varies
Sent To Doctor's office or patient's home
Delivery Time Not specified
Refill Process Company contacts patient to arrange
Limit Only limited by manufacturer's guidelines
Re-application New application yearly
   

Additional Information
Some medications are available for a fee of $20 for up to a 180 day supply.
Check the website for the exact price.

Contact Program for Spanish Application(s)/Form(s)



Don't qualify for this program?
Visit the DBAs to look for financial assistance based on your diagnosis.
Program 2 of 2. Updated April 14, 2014
Diflucan

Pfizer RxPathways Savings Card

This is a discount card program.

Provided by: Pfizer, Inc.


TEL: 866-706-2400


ALT PHONE:
FAX: 		Languages Spoken:

English

Program Website
 

Patient Assistance Applications

 Pfizer RxPathways Savings Card: Contact program
 

Medications
  • Diflucan Tablet 100mg, 200mg (fluconazole)
 

Eligibility Requirements
Insurance Status Must have no prescription coverage
Those with Part D Eligible? No
Income Not Required
Diagnosis/Medical Criteria Medically appropriate condition
US Residency Required? Must reside in the US, Puerto Rico or the USVI
   

Application
Obtaining No application
Receiving Not applicable
Returning Not applicable
Doctor's Action Give prescription to patient
Applicant's Action Call to enroll
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication
Amount/Supply Not applicable
Sent To Card sent to doctor's office or to patient's home
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information