Contact info
- Phone
- 1-844-265-8027
- Fax
- 1-844-845-2323
- Mailing address
- 600 Emerson Road3RD Floor, Suite 300Creve Coeur, MO 63141
Eligibility
- Program provides free medication to qualifying patients.
- Patient must meet program income guidelines.
- Patients with Medicare Part D may be eligible, contact program for details.
- Income limit, single
- 600% of the federal poverty level
- Income limit, couple
- 600% of the federal poverty level
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Yes
- US citizenship or residency required
- Yes
Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).
Application process
- Documents to attach
- Proof of income
- Prescriber license number
- NPI number
- Both DEA and state license numbers
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider and patient
Getting the medication
- Patient receives
- Medication
- Shipped to
- Provider or patient
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- Not published
Medications covered
- Duopa (carbidopa/levodopa enteral suspension)