Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Amneal Patient Assistance Program

This program provides medication at no cost.

Provided by: Amneal Pharmaceuticals LLC.

PO Box 220586
Charlotte, NC 28222

TEL: 877-764-9021


FAX: 877-764-9022
Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

Amneal Patient Assistance Program Application (Emverm)

Amneal Patient Assistance Program Application (Rytary)

 

Medications

  • mebendazole tablet; chewable (Emverm) Tablet; Chewable
 

Eligibility Requirements   

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

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

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


Updated May 09, 2022