The AZ&Me Prescription Savings program for people without insurance is designed to provide AstraZeneca medicines at no cost to qualified patients. This patient prescription assistance program can help patients who do not have prescription drug coverage and who meet other eligibility criteria. Highlights 1. AstraZeneca medicines provided at no cost 2. There is NO cost to sign up for the program 3. Once accepted, you remain enrolled for up to one year. At the end of that year you can reapply. 4. Medicines are mailed to the home or physician's office 5. You or your doctor can request refills. 6. Apply by phone or download an application at www.azandme.com.Are you eligible? You may be eligible if you meet the following criteria: 1. You have an annual household income* at or below: $35,000 for a single person $48,000 for a family of two $60,000 for a family of three $70,000 for a family of four $80,000 for a family of five * Income limits may be higher in Alaska and Hawaii. 2. You do not receive prescription drug coverage under any private insurance or any other coverage that provides assistance to help pay for medicines, such as: Employer furnished or private prescription drug coverage VA or Military Benefits Medicaid Medicare Part A Medicare Part B (covers some injectable medicines) Medicare Part D* State assistance program for medicines (SPAP, SCHIP, PACE, etc.). How to apply The AZ&Me Prescription Savings program for people without insurance offers an easy application process that can help you receive your AstraZeneca medicines quickly. To apply to the Program: 1. Download the application at www.azandme.com or call 1-800-AZandMe (292-6363). 2. Include the required financial information and your signature. * Acceptable forms for financial documentation include a copy of last year's federal income tax returns for yourself, your spouse and dependents, a Social Security Benefit Verification Statement or all income statements from jobs (W-2 or 1099) 3. If you are not a US citizen, you must also provide a valid US Green Card number or a confirmation letter from the government stating that you have applied for a US Green Card or a Work Visa number. 4. Include a valid prescription for your AstraZeneca medicine(s) from your doctor. 5. Mail the completed application, financial information, and prescription(s) to: AZ&Me Prescription Savings Programs PO Box 898, Somerville, NJ 08876OR Fax: 1-800-961-8323 If you have questions about the application process, or to learn more about whether or not you or a family member may qualify for this program, call 1-800-AZandMe (292-6363), Monday through Friday, 8:00 AM TO 6:00 PM EST.
Contact Information
AZ&Me Prescription Savings Program
PO Box 898
Somerville, NJ 08876
1-(800) 292-6363 (phone)
1-(800) 961-8323 (fax)
1-1-800-AZandMe (vanity_phone)
Physician requests should be directed to:
AZ&Me Prescription Savings Program
P.O. Box 898
Somerville, NJ 08876
1-(800) 292-6363 (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Eligibility:
Patient applications are evaluated on a case-by-case basis by the Program. Eligibility is based on income levels and absence of private prescription insurance, third-party coverage, or participation in a public program including the Medicare Limited-Income Subsidy. Income eligibility is based on levels at or below $35,000 for an individual; $48,000 for a couple; $60,000 for family of three; $70,000 for a family of four. The Program requires proof of of income and US residency (Social Security #, work visa # or green card #). Patients approved into the Program will receive an acceptance letter and should receive their shipment of product within 1-2 weeks. Patients denied to the program will receive a denial letter if the individual does not meet the eligibility guidelines of the Program. Enrollment is for 12 months with reapplication at month 10.
Other Information:
If you are seeking assistance with CAPRELSA® (vandetanib), please call 1-800-367-4999. Eligibility criteria for CAPRELSA is up to $100,000, regardless of household size.
If you are seeking assistance with MYALEPT™ (metreleptin) for injection, please call 1-855-669-2537.
Product(s) covered by program:
- Arimidex®
- Atacand®
- Atacand® HCT
- Brilinta®
- Bydureon®
- Byetta®
- Crestor®
- Farxiga™
- Faslodex®
- Kombiglyze™XR
- Merrem I.V.®
- Nexium®
- Nexium® I.V. Injection
- Nexium® Oral Suspension
- Onglyza®
- Pulmicort Flexhaler®
- Pulmicort Respules®
- Rhinocort Aqua®
- Seroquel XR®
- Symbicort®
- Symlin®
- Toprol® XL
- Zoladex®
FAQs
The AZ&Me Prescription Savings program for people without insurance is designed to provide AstraZeneca medicines at no cost to qualified patients. This patient prescription assistance program can help patients who do not have prescription drug coverage and who meet other eligibility criteria.
Who is eligible for the Az&Me program? ›
If you are enrolled in Medicare Part D, you may be eligible for the program if you meet the following criteria: 1. Enrolled in Medicare Part D; 2. You are an individual with an annual income at or below $35,000, or if a couple, at or below $48,000; 3.
What is the income limit for AZ&ME for Medicare? ›
| AZ&Me Prescription Savings Program for People with Medicare Part D |
|---|
| , Phone : 800-292-6363 Fax: |
| Eligibility |
| > | The patient must have Medicare Part D, and have an income less than or equal to $30,000 for an individual (less than or equal to $40,000 for a couple.) |
| Who Can Apply |
35 more rowsThese tips may help minimize your prescription drug costs.
- Choose a network pharmacy. ...
- Check into home delivery options. ...
- Order online. ...
- Use discount programs. ...
- Ask for generics when you can. ...
- Switch to a different form of the same drug. ...
- Ask for a 90-day supply. ...
- Reach out to assistance programs.
Farxiga's manufacturer says most health insurance and Medicare Part D plans will cover Farxiga without prior authorization, but it depends entirely on the plan. AstraZeneca's AZ&Me prescription savings program can help uninsured patients get Farxiga for free if they meet certain income requirements.
How to get Breztri for free? ›
BREZTRI Zero Pay
To determine if you're eligible, submit your information on this site, call us at 1-833-458-0440, or ask your doctor for more information. Terms and conditions apply. Government restrictions exclude people enrolled in federal government insurance programs from copay support.
Who is eligible for Janssen CarePath? ›
You may be eligible for the Janssen CarePath Savings Program if you are age 18 or older, use commercial or private health insurance for SIMPONI®, and must pay an out-of-pocket cost for your medication. There is no income requirement.
Which Medicare program pays for prescription drugs for the elderly? ›
In 2003, Congress signed into law the Medicare Prescription Drug, Improvement and Modernization Act. This law includes a prescription drug benefit called Medicare Part D.
What is the maximum out-of-pocket for prescriptions on Medicare? ›
Out-of-pocket costs
Health or prescription drug costs that you must pay on your own because they aren't covered by Medicare or other insurance. will be capped at $2,000, starting in 2025.
What drugs will Medicare pay for? ›
All Part D plans must include at least two drugs from most categories and must cover all drugs available in the following categories:
- HIV/AIDS treatments.
- Antidepressants.
- Antipsychotic medications.
- Anticonvulsive treatments for seizure disorders.
- Immunosuppressant drugs.
- Anticancer drugs (unless covered by Part B)
Drug Assistance Program. Many pharmaceutical companies, state programs and nonprofits have drug assistance programs (PAPs) that offer free or low-cost medicines if you don't have insurance or are underinsured and can't afford your medicine.
How to get a free prescription? ›
You're entitled to free NHS prescriptions if you:
- get certain benefits.
- have a valid maternity exemption certificate.
- have a valid medical exemption certificate.
- have a valid war pension exemption certificate.
- have an HC2 certificate (NHS Low Income Scheme)
Insurance and GoodRx. Sometimes, insurance isn't the best deal — because of high deductibles or high copays, or because maybe your drug isn't covered at all. In many cases, GoodRx prices actually beat insurance prices (a copay or coinsurance charge). The good news is you can use GoodRx instead of insurance.
What is the income limit for Az&Me? ›
You may be eligible if you meet the following criteria: 1. You have an annual household income* at or below: $35,000 for a single person $48,000 for a family of two $60,000 for a family of three $70,000 for a family of four $80,000 for a family of five * Income limits may be higher in Alaska and Hawaii.
How much does a 30 day supply of FARXIGA cost? ›
from $622.61
| Quantity | Per unit | Price |
|---|
| 30 | $20.75 | $622.61 |
| 90 | $20.54 | $1,848.83 |
Patient Assistance Program
AZ&Me™ is designed to help qualifying people without insurance and those on Medicare who are having trouble affording their AstraZeneca medications.
What are the income limits for AstraZeneca? ›
You may be eligible if you meet the following criteria: 1. You have an annual household income* at or below: $35,000 for a single person $48,000 for a family of two $60,000 for a family of three $70,000 for a family of four $80,000 for a family of five * Income limits may be higher in Alaska and Hawaii.
Who is eligible for Merck patient assistance program? ›
You may qualify for patient assistance* if you meet all 3 of the following conditions: You are a US resident and have a prescription for a Merck product from a health care provider licensed in the United States. You do not have insurance or other coverage for your prescription medicine.
What is the poverty level for AstraZeneca? ›
The new annual household income eligibility levels are $35,000 for individuals, $48,000 for couples, $60,000 for a family of three and $70,000 for a family of four.
How to get help paying for Symbicort? ›
How to Get Symbicort Prescription Assistance. The first step is to apply with Simplefill online or call us at 1(877)386-0206.
