Contact info
- Phone
- 1-888-762-6436
Eligibility
- Patient must have lived in the US or its territories for 6 months or longer.
- Patient must meet program income guidelines.
- Patient must uninsured or underinsured.
- For Medicare Part D patients may be eligible, contact program for details.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- 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
- Prescription
- Prescriber license number
- State license number
- 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
- Varies
- Time to first delivery
- Not published
- Refills
- Varies by product
- Staying enrolled
- New application at end of every enrollment period
More from the program
Please visit www.SafetyNetFoundation.com for more information and applications.
Medications covered
- Aimovig (erenumab)
- Aranesp (darbepoetin alfa)
- Blincyto (blinatumomab)
- Enbrel (etanercept)
- Evenity (romosozumab)
- Imdelltra (tarlatamab-dlle)
- Imlygic (talimogene laherparepvec)
- Kyprolis Injection (carfilzomib)
- Lumakras (sotorasib)
- Nplate (romiplostim)
- Otezla Tablet