Berlex Inc Patient Assistance Program (PAP)

Berlex Inc Patient Assistance Program (PAP)

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Berlex Laboratories

Berlex Inc Patient Assistance Program (PAP)

Sponsor Organization
Berlex Laboratories

Prescription Medication Assistance Organization Contact
Berlex Laboratories, Inc
Patient Assistance Program (PAP)
PO Box 1000, M2/1-5
Montville, NJ 07045-1000
(973) 305-3545
Phone: (888) 237-5394 Option 6, then Option1

Medications sent to: Patientís Doctor

Prescription Medications/Products Covered:
Betapace AF
Climara Pro

Program Eligibility Requirements:
To be accepted into the Berlex Patient Assistance Program (PAP), a patient must meet the following criteria:
1) must be a US citizen
2) must be ineligible for any public or private health insurance, including Medicare and Medicaid and any other state or private programs
3) must have an annual gross family income of $20,000 or less
(Annual Gross Family Income includes salary, Social Security, disability payments, pension benefits, unemployment, etc. and must include spouse's income if married)
4) must be eligible for Medicare but ineligible for prescription coverage and must have an annual gross family income of $15,000 or less
5) must be under the care of a doctor/prescriber who has prescribed Betapace, Betapace AF, or Climara as medically appropriate for the patient applying for assistance

Additional Information and/or Requirements (known):
To apply, the doctor/prescriber's office should call the Berlex toll-free number:
(888) 237-5394, Option 6, Option 1, between 9 a.m. and 5 p.m. EST

Completed Application Forms will be reviewed and approved by the Berlex Patient Assistance Program (PAP). If the patient is eligible, the doctor/prescriber's office will receive up to a three-month supply of medication usually within a week to 10 days. For further information, please call the Berlex Patient Assistance Program (PAP).




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