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

ENcourage Foundation

This program provides brand name medications at no or low cost

Provided by: Amgen and Pfizer

PO Box 5730
Louisville, KY 40255-0730

TEL: Closed Program


ALT PHONE: 800-282-7752
FAX: 888-508-8083
Languages Spoken:

English, Spanish

 

Patient Assistance Applications

 

Generic Name Medications Covered

 
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Considered on exception basis
Income Income Guidelines published on Program Website
Diagnosis/Medical Criteria Not applicable
US Residency Required? Must reside permanently in the US, Guam, Puerto Rico or US Virgin Islands
   

Application

Obtaining Call or download
Receiving Mailed or downloaded from website
Returning Fax from Doctor's office
Doctor's Action Sign and provide prescription information
Applicant's Action Complete section and sign
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe 2-5 business days
   

Medication

Amount/Supply Varies
Sent To Patient's home, doctor's office, hospital or pharmacy
Delivery Time Within 5-7 business days
Refill Process Company contacts patient or doctor to arrange
Limit None
Re-application New application every 12 months
   

Additional Information

Closed Program 12/15/2015

Physician must complete the Product Prescription Form or submit an original script.

The Safety Net Foundation will begin administering the EnbrelŪ free goods program with 2016 enrollments. While these changes do not take effect until next year, to ensure that patients applying for enrollment in January 2016 use the correct application form please.


Updated January 25, 2016