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This program provides generic medications at a discount.
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| Pharmaceutical Company |
Express Scripts Specialty Distribution Services |
| Program Name |
Rx Outreach Medications |
| Program Address |
PO Box 66536
St Louis, MO 63166-6536 |
| Phone Number |
800-769-3880
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| Fax Number |
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| Medications on Program |
diclofenac Tablets 25mg, 50mg, 75mg (Voltaren)
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| Application Forms |
Rx Outreach
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On-line Application
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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. have an income at or below 300% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. This program is for generic medications only.
Many medications are available for a fee of $20 for up to a 180 day supply. Prices vary for Tier 2 and Tier 3 medications. Please refer to the Rx Outreach website for more information.
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| Application Process |
Anyone requesting assistance can call to request a faxed application or download it from the website. The application can be either faxed or mailed out upon request. The completed application must be mailed back.
The patient is notified of eligibility for the program.
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| Application Requirements |
The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.
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| Program Details |
The medication is sent to either the doctor's office or the patient's home. The patient must contact the company to arrange for refills. Every year a new application is needed.
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| Last Updated |
July 08, 2010 |
