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

Diplomat's Co-Pay Assistance Navigator Program

This is a copay assistance program

Provided by: Diplomat Specialty Pharmacy

TEL: Closed Program

Languages Spoken:



Patient Assistance Applications


Generic Name Medications


Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? Yes
Income Determined case by case
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Yes


Obtaining Call or complete online
Receiving Faxed, mailed or complete online
Returning Fax or mail
Doctor's Action Will be discussed with patient and Doctor after request is received
Applicant's Action Complete section, sign and provide annual income information. Proof of income may be request by program at any time
Decision Communicated
Decision Timeframe


Sent To
Delivery Time
Refill Process
Re-application Determined case by case

Additional Information

Closed Program

Diplomat Specialty Pharmacy is a full service pharmacy that can help patients seek funding assistance for the copay portion of their required medications. Applications can be completed online or Prescription, Demographics and Proof of Income may be faxed to 810-282-0176 Attn: Dorrie

Updated February 02, 2017