Contact info
- Phone
- 1-877-864-8437
Eligibility
- Enroll Online
- Program offers a free medication program for uninsured and underinsured patients who meet eligibility requirements.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Not published
- 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
- Not published
- Who can sign
- Physician
- Application can be faxed
- Not published
- Decision letter sent to
- Not published
Getting the medication
- Patient receives
- Not published
- Shipped to
- Not published
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- Not published
Medications covered
- Adcirca tablets (tadalafil)
- Orenitram tablet; extended release (treprostinil)
- Remodulin injection (treprostinil)
- Tyvaso DPI (treprostinil inhalation powder)
- Tyvaso inhalation solution (treprostinil)