1-877-242-2738, 1-866-474-8326

Those with federal health care or Massachusetts state coverage are not eligible.  Patient must have less than $25,000 in monthly household income AND meet one or more of the following: 1)has changed jobs or stopped working and has COBRA or HIPAA coverage 2) has insurance, but has exclusion period.  The medication must be used for a FDA-approved diagnosis. Patient must reside in the US, be under the direct care of a licensed US physician and receive health care services via the US health care system. Another number for the program is 866-344-4874. Patient will be excluded from this program if they lose insurance coverage by accepting PAP product. Patient financial, medication and insurance information is collected and reevaluated quarterly.

The doctor or patient can call to request an application.      

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

The medication is sent to either the doctor's office or the patient's home.  Patient are eligible for a maximum of six months or until they are able to obtain third party insurance, whichever comes first.

877-242-2738, 866-474-8326

Those with federal health care or Massachusetts state coverage are not eligible.  Patients must meet the following criteria: 1) Insufficient financial resources to pay for treatment 2)Income is not more than 300% FPL and patient has documented proof that they don't have insurance coverage 3)A written denial from a state Medicaid program. The medication must be used for a FDA-approved diagnosis. Patient must reside in the US, be under the direct care of a licensed US physician and receive health care services via the US health care system.  This program is available through 3 distributors, patients may also call 1-866-474-8326. Income, medication and insurance verification will be required quarterly.

The doctor or patient can call to request an application. The application can be either faxed or mailed out upon request.     

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 and any insurance information.

Not applicable.

866-474-8326, 866-344-4874

Patient mustn't have access to coverage from fed govt or MA programs. They may have insurance coverage BUT the only source of coverage is a policy with a lifetime cap on benefits and the patient is within $300,000 of reaching that lifetime cap. Has a household income below $25,000. The medication must be used for a FDA-approved diagnosis. Patient must reside in the US, be under the direct care of a licensed US physician and receive health care services via the US health care system. The patient may also call 1-877-242-2738. A statement from the insurer documenting that the patient is within $300,000 of exhausting a lifetime cap on his or her insurance benefits is required. Eligibility terminates if the patient obtains new insurance. Patient household income and insurance status is re-evaluated quarterly.

The doctor or patient can call to request an application. The application can be either faxed or mailed out upon request.     

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 and any insurance information.

Not applicable.