RxMedConnection
Saving
participants over $3 million - and counting!
RxMedConnection
is a prescription assistance program that assists individuals in
obtaining medication from the patient assistance programs of the major
pharmaceutical manufacturer's.
For a
low monthly processing fee of $15.00
per client, RxMedConnection helps to link those with fixed incomes and
low incomes to pharmaceutical companies patient assistance programs.
Over 2,500 different medications are available. Timeline to begin
receiving medications is 6-8 weeks.
Eligibility
Requirements: To
be eligibile for this program gross annual household income must not
exceed: $26,000 - $28,000 for a household of two; $16,000 -
$19,000 for a household of one.
Annual
income requirements for Cancer and AIDS patients can go as high as
$60,000. Income qualifications may vary among pharmaceutical companies.
Persons
interested in enrolling in this program must be uninsured for
prescription drug coverage. Prescription drug coverage does not
include drug discount cards, which pay less than 50% of the cost of the
medicine.
RxMedConnection
charges a $15 per month processing fee per enrolled client (not
medication) for this service. This monthly fee does not
include the processing fee that may be charged by local pharmacies for
labeling medications that are received unlabeled.
Enrollment:
To enroll
in the RxMedConnection Medication Assistance Program follow these simple
steps:
-
Obtain
an application form from the Network's offices, call, or send a
request for an application to:
RxMedConnection
117 W. Houston St.
Jasper, Texas 75951
Phone: (409) 384-2099
Fax: (409) 384-2211.
Complete both Part A (Basic Data and Financial Information) and
Part B (Medical Provider's Information, Prescribed Medications,
and Authorization to Release Patient Information) of the attached
application form. You need only complete one form for all
medications requested.
-
Mail
your completed application form to RxMedConnection with the
following:
-
A
check or money order for the first month processing fee of
$15. On or about the 1st of each month you will receive a
statement for $15 as a reminder that the next payment is
due.
Note:
Payment must be received before applications or reorders are
processed.
-
A
current list of medications from your doctor.
-
Income
verification, which may include one or more of the
following:
-
Federal
Income Tax Return from prior year with all attachments
IF required to file.
-
Current
Year Award Letter from Social Security (Call
1-800-772-1213 to obtain a copy)
-
Copy
of any Retirement or Annuity check received by patient,
spouse, or both.
-
If
employed, 3 most current pay stubs or bank statements if
direct deposited.
-
Copy
of Medicare Card (front & back) if on Medicare.
-
Your
physician's cooperation is required to sign prescription
assistance applications. RxMedConnection will mail your physician
the appropriate application forms to sign. Once signed, your
physician returns the applications to RxMedConnection for
processing. Medications are generally received within 6-8 weeks of
mailing the initial applications.
-
If
the pharmaceutical company approves your application, your
medication will be sent directly to your physician (some
manufacturers may ship directly to the patient).
Note:
RxMedConnection cannot guarantee the shipment date of
medications ordered through the Prescription Assistance Program.
Patients are responsible for maintaining an adequate supply of
medications at all times and at their own expense.
Have
questions? Not sure if you qualify? Call the Network office at (409)
384-2099, our staff.htm is always happy
to answer your questions. If you are determined to be ineligible to
participate in this program you will be given a full refund.
"Together We Achieve the
Extraordinary!"
