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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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program - Pulmonary Arterial Hypertension (PAH) ProductsThis program provides medication at no cost. @if> |
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Provided by: Johnson & Johnson Patient Assistance Foundation, Inc. |
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610 Crescent Executive Court TEL: 833-919-3510ALT PHONE: 308-920-4358 FAX: 833-919-3509 |
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 Assistance Program (PAH) Application |
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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? | *See Additional Information Section Below | ||
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 proof of income | ||
Decision Communicated | Patient and Doctor notified in writing | ||
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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*Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. Please Contact the program for more information (1-833-929-3510). **Please call 1-833-929-3510 or visit Program website for specific FPL income requirements. |
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Updated April 14, 2022 |
Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
Program 2 of 2. | |||
Patient Access Network Foundation (PAN)This is a copay assistance program @if> |
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Provided by: Patient Access Network Foundation |
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TEL: 866-316-7263FAX: 866-316-7261 |
Languages Spoken:
English, Spanish, Others By Translation Service |
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Program Applications and Forms |
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Patient Access Network Foundation (PAN) Application: Contact program |
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Medications |
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Eligibility Requirements |
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Insurance Status | *See Additional Information section below | ||
Those with Part D Eligible? | Determined case by case | ||
Income | Between 400-500% of FPL | ||
Diagnosis/Medical Criteria | FDA Approved Diagnosis - See Program Website for Details | ||
US Residency Required? | Must reside and receive treatment in US | ||
Application |
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Obtaining | Call or complete online | ||
Receiving | Complete online or by phone | ||
Returning | Complete online or by phone | ||
Doctor's Action | Will be discussed with patient and Doctor after request is received | ||
Applicant's Action | Call for information or inform doctor that he/she is in need | ||
Decision Communicated | Patient and Doctor notified in writing | ||
Decision Timeframe | Within 48 hours | ||
Medication |
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Amount/Supply | Not applicable | ||
Sent To | Patient sent card to be used at pharmacy | ||
Delivery Time | Once approved; shipped same day | ||
Refill Process | Patient presents voucher/card to pharmacy for each refill | ||
Limit | None | ||
Re-application | New application every 12 months | ||
Additional Information |
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*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details. |
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Updated April 25, 2022 |