800-999-6673

The patient must be uninsured and meet income guidelines that are not disclosed. The patient must be diagnosed with Spasticity. The patient must also be a US resident. Patient must call this program first to be prescreened. Then the program refers the call to NORD and NORD sends out the application and makes the decision. The prescription must be for the brand name Zanaflex Capsules only.

The patient must call for a prescreening. The application is sent to the patient within 2 weeks. The completed application must be mailed back.   The estimated timeline is 3-5 business days. 

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

Up to a 90-day supply is sent to the doctor's office or the patient's home. The company automatically sends out refills. The company will contact the patient regarding reapplication.

800-769-3880

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.

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.  

The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.

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.

866-699-8239

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.

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.

The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.

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.

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.