| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
| Program 1 of 2. Scroll down to see them all. |
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Eliquis |
View Coupon |
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Bristol Myers Squibb (BMS) Patient Support Program (Expanded: COVID-19)This program provides brand name medications at no or low cost |
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Provided by: Bristol-Myers Squibb Company |
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TEL: 800-721-8909 |
Languages Spoken:
English, Others By Translation Service |
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Program Applications and Forms |
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Bristol Myers Squibb (BMS) Patient Support Program (Expanded: COVID-19) |
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Bristol Myers Squibb (BMS) Patient Support Program (Expanded: COVID-19) (Spanish) |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Determined case by case | ||
| Those with Part D Eligible? | Determined case by case | ||
| Income | Not disclosed | ||
| Diagnosis/Medical Criteria | FDA-approved diagnosis | ||
| US Residency Required? | Must reside in the US | ||
Application |
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| Obtaining | Call | ||
| Receiving | Not specified | ||
| Returning | Not specified | ||
| Doctor's Action | Not specified | ||
| Applicant's Action | Call for information or inform doctor that he/she is in need | ||
| Decision Communicated | Call for decision | ||
| Decision Timeframe | Varies | ||
Medication |
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| Amount/Supply | Varies | ||
| Sent To | Varies | ||
| Delivery Time | Varies | ||
| Refill Process | Not specified | ||
| Limit | Contact the program for details | ||
| Re-application | Determined case by case | ||
Additional Information |
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| Eligibility determined on a case-by-case basis. Contact program for details: 1-800-721-8909 |
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| Updated May 17, 2021 | |||
| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
| Program 2 of 2. | |||
Eliquis |
View Coupon |
||
Bristol-Myers Squibb Patient Assistance Foundation (BMSPAF)This program provides brand name medications at no or low cost |
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Provided by: Bristol-Myers Squibb Company |
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PO Box 220769 TEL: 800-736-0003FAX: 800-736-1611 |
Languages Spoken:
English, Spanish, Others By Translation Service |
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Program Applications and Forms |
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Bristol-Myers Squibb Patient Assistance Foundation Application |
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Bristol-Myers Squibb Patient Assistance Foundation Application (Zeposia) |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Must have no prescription coverage for needed medication | ||
| Those with Part D Eligible? | Considered on exception basis | ||
| Income | At or below 300% of FPL | ||
| Diagnosis/Medical Criteria | Medication must be for outpatient use only | ||
| US Residency Required? | Must reside in the US, Puerto Rico or the USVI | ||
Application |
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| Obtaining | Call or download | ||
| Receiving | Faxed | ||
| Returning | Fax or mail | ||
| Doctor's Action | Complete section and sign | ||
| Applicant's Action | Complete section, sign, attach required documents | ||
| Decision Communicated | Patient and Doctor notified in writing | ||
| Decision Timeframe | Within a week | ||
Medication |
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| Amount/Supply | Varies | ||
| Sent To | Doctor's office | ||
| Delivery Time | Within 5-7 business days | ||
| Refill Process | Doctor/Doctor's office must contact company | ||
| Limit | None | ||
| Re-application | New application yearly | ||
Additional Information |
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| Co-payment assistance and patient assistance programs are available for eligible patients. |
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| Updated June 11, 2021 | |||
