Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
MyPraluent Patient Assistance Program (PAP)This program provides brand name medications at no or low cost @if> |
|||
Provided by: Regeneron Pharmaceuticals, Inc. |
|||
PO Box 592188 TEL: 844-772-5836FAX: 844-855-7278 |
Languages Spoken:
English, Spanish |
||
Program Applications and Forms |
|||
MyPraluent Patient Assistance Program (PAP) Enrollment Form |
|||
MyPraluent Electronic Enrollment |
|||
Medications |
|||
|
|||
Eligibility Requirements |
|||
Insurance Status | Must be uninsured or underinsured | ||
Those with Part D Eligible? | Yes, but contact program for details | ||
Income | At or below 300% of FPL | ||
Diagnosis/Medical Criteria | FDA-approved diagnosis | ||
US Residency Required? | Must live in US, DC or Puerto Rico | ||
Application |
|||
Obtaining | Call, download or apply online | ||
Receiving | Complete online, download from website or faxed. | ||
Returning | Fax or mail | ||
Doctor's Action | Complete section, sign, attach required documents | ||
Applicant's Action | Complete section, sign, attach required documents | ||
Decision Communicated | Patient and Doctor are notified | ||
Decision Timeframe | Varies | ||
Medication |
|||
Amount/Supply | As prescribed by Doctor | ||
Sent To | Patient's home | ||
Delivery Time | Varies | ||
Refill Process | Patient requests refills via a toll-free number | ||
Limit | Varies | ||
Re-application | New application yearly | ||
Additional Information |
|||
Co-payment assistance, and patient assistance programs are available for eligible patients. |
|||
Updated June 26, 2023 |