| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
| Program 1 of 3. Scroll down to see them all. |
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Spravato |
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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance ProgramThis program provides medication at no cost. |
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Provided by: Johnson & Johnson Patient Assistance Foundation, Inc. |
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Patient Assistance Program TEL: 800-652-6227FAX: 888-526-5168 |
Languages Spoken:
English, Spanish, Others By Translation Service |
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Program Applications and Forms |
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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Application |
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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Application: Imbruvica, Sirturo |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Contact program for details. | ||
| Those with Part D Eligible? | Contact program for details. | ||
| Income | Varies. *See below for details | ||
| Diagnosis/Medical Criteria | Medication must be for outpatient use only | ||
| US Residency Required? | Must reside permanently in the US or US territories | ||
Application |
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| Obtaining | Call or download | ||
| Receiving | Faxed, mailed or downloaded from website | ||
| 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 are notified | ||
| Decision Timeframe | 3-5 business days | ||
Medication |
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| Amount/Supply | Not specified | ||
| Sent To | Doctor's office or patient is sent card to be used at pharmacy | ||
| Delivery Time | Varies | ||
| Refill Process | Varies per medication | ||
| Limit | Varies | ||
| Re-application | New application, new documentation yearly | ||
Additional Information |
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| *Please call (800) 652-6227 or visit Program website for specific FPL income requirements. |
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| Updated August 18, 2023 | |||
| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
| Program 2 of 3. Scroll down to see them all. |
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Spravato |
View Coupon |
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Janssen CarePathThis program provides brand name medications at no or low cost |
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Provided by: Janssen |
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TEL: 877-227-3728ALT PHONE: 833-742-0791 |
Languages Spoken:
English, Spanish, Others By Translation Service |
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Program Applications and Forms |
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Janssen CarePath Enrollment Portal |
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Janssen CarePath Patient Assistance Enrollment Form
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Janssen CarePath Patient Assistance Enrollment Form (For Pulmonary Hypertension) |
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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? | Varies | ||
| Income | Not applicable | ||
| Diagnosis/Medical Criteria | Must be used for on-label diagnosis | ||
| US Residency Required? | Must be citizen or legal resident | ||
Application |
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| Obtaining | Applicant must call for prescreening | ||
| Receiving | Patient is contacted if eligible after phone screening | ||
| Returning | Varies | ||
| Doctor's Action | Complete section, sign, attach required documents | ||
| Applicant's Action | Call for information or inform doctor that he/she is in need | ||
| Decision Communicated | Patient and Doctor are notified | ||
| Decision Timeframe | Varies | ||
Medication |
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| Amount/Supply | Varies | ||
| Sent To | Varies | ||
| Delivery Time | Varies | ||
| Refill Process | Patient or Doctor must contact company | ||
| Limit | Not specified | ||
| Re-application | New application, new documentation yearly | ||
Additional Information |
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| Patient Support and co-payment assistance available for eligible patients. Call for most recent medications as the list is subject to change. |
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| Updated September 15, 2023 | |||
| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
| Program 3 of 3. | |||
Spravato |
View Coupon |
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HealthWell Foundation Copay ProgramThis is a copay assistance program |
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Provided by: HealthWell Foundation |
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TEL: 800-675-8416 |
Languages Spoken:
English, Others By Translation Service |
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Program Applications and Forms |
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HealthWell Foundation Copay Program Enrollment: Contact program |
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Medications |
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Eligibility Requirements |
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| Insurance Status | May have insurance | ||
| Those with Part D Eligible? | Yes, but contact program for details | ||
| Income | Varies | ||
| Diagnosis/Medical Criteria | FDA Approved Diagnosis - See Program Website for Details | ||
| US Residency Required? | Must reside in the US | ||
Application |
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| Obtaining | Call or complete online | ||
| Receiving | Varies | ||
| Returning | |||
| Doctor's Action | Complete section and sign | ||
| Applicant's Action | Complete section, sign, attach required documents | ||
| Decision Communicated | Patient notified | ||
| Decision Timeframe | 3-5 business days | ||
Medication |
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| Amount/Supply | Not applicable | ||
| Sent To | Varies | ||
| Delivery Time | Not specified | ||
| Refill Process | Automatically sent out | ||
| Limit | Contact the program for details | ||
| Re-application | New application every 12 months | ||
Additional Information |
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| This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease. Call for most recent medications as the list is subject to change. |
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| Updated September 25, 2023 | |||
