1). Prescription Bliss

www.prescriptionbliss.com

Eligibility:
• Each program has different requirements, but many of our
patients come to us who are on Medicare and have a Part D plan and are unable to afford their copays or find themselves in the coverage gap of their prescription plan.
• If your insurance company has denied paying for your prescriptions or you have a high copay or coinsurance responsibility.

Instructions:
• Call 1-877-792-5477 or go to the website prescriptionbliss.com to apply
• Click on Apply Now
• Click on Begin Application


2.) RX Assistant

www.rxassistantprograms.com

Eligibility:
Its best to call to see if you qualify.
• U.S. citizen or resident
• Does not have insurance or insurance doesn't cover medication.
• On Medicare or in donut hole/coverage gap

Instructions:
• Go to rxassistantprograms.com to fill out online form
• Call 1-888-344-8915


3). https://www.boehringer-ingelheim.us/our-responsibility/patient-assistance-program

Eligibility:
• Be a resident with a physical address within the United States or US Territory
• Have one of the insurance coverage circumstances either no health coverage or not enough coverage to obtain the medication (eligible drugs are listed below)
• Not have access to alternate sources of coverage or funding for your medication
• Meet household income guidelines established by BI Cares

The following medications are eligible for the BI Patient Cares Assistance Program:
Aptivus Capsules, Atrovent HFA, Combivent Respimat, Glyxambi, Jardiance, Jentadueto, Jentadueto XR, Spiriva HandiHaler, Spiriva Respimat, Stiolto Respimat, Striverdi Respimat, Synjardy, Synjardy XR, Tradjenta, Trijardy XR

Instructions:
• Apply online at website above or call 1-800-556-8317
Please complete one of our online applications, whichever applies to you and follow the instructions on the application for submission