| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
Amneal Patient Assistance ProgramThis program provides medication at no cost. |
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Provided by: Amneal Pharmaceuticals LLC. |
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PO Box 220586 TEL: 877-764-9021FAX: 877-764-9022 |
Languages Spoken:
English, Others By Translation Service |
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Program Applications and Forms |
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Amneal Patient Assistance Program Application (Emverm) |
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Amneal Patient Assistance Program Application (Rytary) |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Must be uninsured or underinsured | ||
| Those with Part D Eligible? | Yes, but contact program for details | ||
| Income | Based on FPL | ||
| Diagnosis/Medical Criteria | Not disclosed | ||
| US Residency Required? | Must reside in the US, Puerto Rico or the USVI | ||
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, sign, attach required documents | ||
| Applicant's Action | Complete section and sign | ||
| Decision Communicated | Patient and Doctor are notified | ||
| Decision Timeframe | Not specified | ||
Medication |
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| Amount/Supply | Contact the program for more details. | ||
| Sent To | Patient's home | ||
| Delivery Time | Contact Program for Details | ||
| Refill Process | Contact program for details. | ||
| Limit | One year | ||
| Re-application | Company contacts patient about reapplying | ||
Additional Information |
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| Updated May 09, 2022 | |||
