Terms
of Use
RxMedsAdvisor
makes every effort to supply the most accurate, reliable information. However,
it does not guarantee or warrant that the information on this web site is
up-to-date. We update regularly all changes to program requirements and
applications on a weekly basis from the Pharmaceutical companies offering these
programs.
We
assume no responsibility for the use or application of any posted material. This
web site is intended solely for the purpose of electronically providing our
members with patient assistance program information and convenient access to the
online information. We assume no responsibility for any error, omissions or
other discrepancies between the electronic and printed versions of documents.
If you are seeking specific advice or counseling, you should contact a licensed
medical practitioner or professional, a social services agency representative,
or an organization in your local community.
We do not guarantee your approval for patient assistance programs. Each drug
manufacturer company determines the eligibility criteria for its patient
assistance program (eligibility criteria and the application process vary). The
general eligibility criteria include income requirements, household size and
status of prescription insurance coverage.
If you have insurance such as Medicare, Medicaid or private coverage, you may
qualify for discount generics and a discount card only.
Some companies will only consider a patient eligible for approval if their
income does not exceed the federal poverty guidelines. Many accept patients if
their income is 200% of the federal poverty guidelines. Some accept patients
with higher incomes. Federal poverty levels can be found at:
http://aspe.hhs.gov/poverty/07poverty.shtml
2007 HHS Poverty Guidelines
|
Persons
in Family or Household
|
48
Contiguous
States and D.C.
|
Alaska
|
Hawaii
|
|
1
|
$10,210
|
$12,770
|
$11,750
|
|
2
|
13,690
|
17,120
|
15,750
|
|
3
|
17,170
|
21,470
|
19,750
|
|
4
|
20,650
|
25,820
|
23,750
|
|
5
|
24,130
|
30,170
|
27,750
|
|
6
|
27,610
|
34,520
|
31,750
|
|
7
|
31,090
|
38,870
|
35,750
|
|
8
|
34,570
|
43,220
|
39,750
|
|
For each additional
person, add
|
3,480
|
4,350
|
4,000
|
SOURCE: Federal
Register, Vol. 72, No. 15, January 24, 2007, pp. 3147–3148
We link
to web sites maintained by other entities. Reasonable precautions are taken to
link only to web sites which are appropriate, accurate and maintained by
reputable organizations. However, those web pages are not under our control and
we are not responsible for any information or opinions expressed in those linked
sites.
THIS
IS NOT INSURANCE
Please read the statement below
I have
completely filled out and am submitting the Membership Eligibility Form and
would like to enroll in RxMedsAdvisor.
I
understand:
-
that not all medications I am taking may be available
through the pharmaceutical companys' free brand or discount generic drug
programs.
-
that pharmaceutical companies have certain criteria
that must be met and that the pharmaceutical companies will make the final
decision as to who qualifies for their programs.
-
In order for me to use this website and download forms
provided so that I may receive free or discounted medication, I will be
charged a one-time lifetime non-refundable application fee of $20.00 plus
$19.95 for the first month - then $19.95 per month thereafter.
-
In order to receive the additional benefits offered;
ie, prescription drug discounts, automotive discounts, roadside assistance
(sign and drive program), dining discounts, health & wellness, entertainment
and recreation, members will be charged an addition $9.95 per month and
non-members will be charged $14.95 per month
Below
are GENERAL GUIDELINES established for the pharmaceutical companies
Patient Assistance Programs:
1) My
gross annual family income is an eligibility requirement. Total Gross Taxable
Income includes: wages, social security, pension, disability, interest earnings,
etc. (Excessive liquid assets may disqualify you from being approved for one or
more medications.)
2) I
currently have no coverage (insurance or government program) that reimburses or
pays for my prescription medications, and I am experiencing a hardship in
purchasing them.
3) I may cancel my membership at any
time, but no refund will be issued as benefits are established
on
a one year basis and paid monthly. Within 60 days of enrollment RxMedsAdvisor
will notify me of the refill requirements for all my medications and continue
service available to me for any new medications or changes in medication during
my paid membership period.
4) I
will be required to provide proof of my income to be sent with my applications,
or if I have zero income I will attach a Self Declaration of Income letter
signed by my doctor or a social worker.
5) That
the pharmaceutical company determines whether my medication is shipped to my
physician, picked up at a local pharmacy, or shipped directly to my home.
Neither RxMedsAdvisor nor I can decide where medications are to be
delivered.
6) That,
with regard to the pharmaceutical companies PAPs, RxMedsAdvisor acts as a
web-based processing assistant to supply all applications and other forms
necessary to receive Free Brand or discount generic drugs offered by
pharmaceutical companies; RxMedsAdvisor does not manufacture drugs,
prescribe drugs, dispense drugs,
recommend medication, or evaluate prescriptions.
I
attest that the information provided in my eligibility form is complete and
accurate. By my submission of this form, I authorize RxMedsAdvisor to use
the information to pre-qualify me for Patient Assistance Programs. I understand
that any such information provided by me
in this form will be used by
RxMedsAdvisor solely to administer PAP program and those services provided
only by RxMedsAdvisor, but will not be used or disclosed for any other
purposes except as may be required by applicable law.
I
understand that RxMedsAdvisor may not be held responsible in the event I
provide information deemed to be fraudulent.
9-26-07