Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

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BI Cares Patient Assistance Program

This program provides medication at no cost.

Provided by: Boehringer Ingelheim Cares Foundation, Inc.

BI Cares Patient Assistance Program
PO Box 5520
Louisville, KY 40255

TEL: 800-556-8317


FAX: 866-851-2827
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

BI Cares Patient Assistance Program Application

BI Cares Patient Assistance Program Application Instructions

HIV Common Application: Boehringer Ingelheim Cares Foundation, Inc.

 

Medications

  • Pradaxa capsule (dabigatran etexilate)
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Yes, but contact program for details
Income Based on FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or US territory
   

Application

Obtaining Call or download
Receiving Faxed, mailed or downloaded from website
Returning Fax or mail from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient notified in writing
Decision Timeframe Not specified
   

Medication

Amount/Supply Up to 90 day supply
Sent To Patient's home, unless otherwise noted
Delivery Time Not specified
Refill Process Patient or Doctor's office needs to contact company
Limit Not specified
Re-application New application yearly
   

Additional Information

Some Medicare eligible patients who have difficulty meeting their Part D drug costs and who do not qualify for other assistance may be eligible.


Updated July 23, 2019