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Program 1 of 5 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company GlaxoSmithKline
Program Name Bridges to Access
Program Address PO Box 29038
Phoenix, AZ 85038-9038
Phone Number

866-728-4368

Fax Number
Medications on Program Wellbutrin Tablets 75mg, 100mg (bupropion)
Application Forms GSK Bridges to Access
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. The patient must also be a US resident. Bridges to Access has new enrollment instructions. It's no longer required to enroll via an advocate unless the patient requires immediate access to their medicine. Applicants can enroll by mailing a completed application, a current prescription and income documentation. An advocate, however, must call to enroll Bridges to Access applicants who need immediate access to medicine (please see web page http://www.bridgestoaccess.com/ for further details about the two methods of enrollment). The application can be filled out and printed from the website, but each application need an individual number (which the website does automatically.)

Application Process

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 faxed, mailed out or downloaded from website. The completed application must be mailed back.  The patient is notified in writing of acceptance or denial.  

Application Requirements

Not applicable.

Program Details

Up to a 90-day supply is sent to the patient's home. The patient must contact the company to arrange for refills. Once a year the application process must be repeated.

Last Updated August 31, 2010


                                         

Program 2 of 5 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company GlaxoSmithKline
Program Name GSK Access
Program Address PO Box 52046
Phoenix, AZ 85072-2046
Phone Number

866-518-4357

Fax Number 866-518-3994
Medications on Program Wellbutrin Tablets 100mg (bupropion)
Application Forms GSK Access
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 Medicare Part D, and have a low income based on the Federal Poverty Guidelines. Medical diagnosis necessary for this program is not specified. The patient must also be residing in the US. The patient must also have spent $600 dollars on medications through the Medicare Part D plan in the current year.

Application Process

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 will be faxed out. The completed application can be faxed or mailed back.  The patient is notified of eligibility for the program.  

Application Requirements

Not applicable.

Program Details

The patient is sent a pharmacy card. The pharmacy card is good for one year. Every year a new application is needed.

Last Updated June 04, 2010


                                         

Program 3 of 5 Scroll down to see them all.

This program provides generic medications at a discount.
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

Fax Number
Medications on Program bupropion Tablets 75mg, 100mg (Wellbutrin)
Application Forms Rx Outreach
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

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.

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.  

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 patient must contact the company to arrange for refills. Every year a new application is needed.

Last Updated July 08, 2010


                                         

Program 4 of 5 Scroll down to see them all.

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 bupropion Tablets 75mg, 100mg (Wellbutrin)
Application Forms Xubex Patient Assistance Program
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

Applicants with insurance are eligible. This program does not have income limitations. 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 fees for the medications:$20-$45 for a 90 day supply. ($40 or $60 for a 180 day supply and $80 or $120 for a 360 day supply.) Check the website for the exact price. A shipping and ordering fee of $3.85 is charged for each order. 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 04, 2010


                                         

Program 5 of 5.

This is a discount card program.
Pharmaceutical Company Together Rx Access
Program Name Together Rx Access
Program Address PO Box 9426
Wilmington, DE 19809-9944
Phone Number

800-444-4106

Fax Number
Medications on Program Wellbutrin Tablets 75mg, 100mg (bupropion)
Application Forms Not Applicable
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 any medications and have an income at or below $45000 if single, $60000 for a family of 2, $75000 for a family of 3, $90000 for a family of 4, $105000 for a family of 5 Medical diagnosis necessary for this program is not specified.  The patient must not be eligible for Medicare. Most cardholders save between 25%-40% on brand name prescription medications. Each card holder's savings depend on such factors as the particular drug purchased, amount purchased, and the pharmacy where purchased.

Application Process

The patient can enroll online to get their ID number which can be used immediately.      

Application Requirements

Not applicable.

Program Details

The patient is sent a Together Rx Access prescription savings card.  

Last Updated May 10, 2010