Simply call 1.800.4HUMIRA (1.800.448.6472) and speak to one of our Insurance Specialists to see if this option is right for you.*Terms and Conditions apply. This benefit covers HUMIRA® (adalimumab) alone or, for rheumatology patients, HUMIRA plus one of the following medications: methotrexate, leflunomide (Arava®), or hydroxychloroquine (Plaquenil®). Pictures of plaquenil pills Plaquenil treatment for vasculitis Eligibility Pre-screen Select a Different Disease Fund Search for and select covered medications. If you do not find the medication on the list, please contact the PAN Call Center at 1-866-316-7263. Immunology Assistance Programs co-pay assistance and patient assistance programs 1-877-423-6597, assistance available in Spanish and other languages; Offers cost-saving coupons and vouchers for GSK medications Free trial offers; Dollars-off coupons; Point of Sale Voucher Program This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. Eligibility: Available to patients with commercial prescription insurance coverage for HUMIRA who meet eligibility criteria. Hydroxychloroquine copay assistance program Welcome to HealthWell’s Online Application, Co-pay Cards and Financial Assistance for Arthritis. Hydroxychloroquine sulfate mechanism of actionIs hydroxychloroquine used for painHydroxychloroquine eye problemsPlaquenil 200 mg malárieWhat is chloroquine given for You may qualify for the Teva Cares ® Foundation Cyclosporine Oral ® Patient Assistance Program if you answer “YES” to the following questions You have been prescribed Cyclosporine Oral ®. You do not have prescription drug coverage. Your yearly household income does not exceed the following Do I Qualify? -. NeedyMeds. Rx Assistance Programs - Apply Online Now Simplefill. PAN Foundation - Disease Fund Rheumatoid Arthritis. Actemra tocilizumab Actemra Actpen tocilizumab Active Injection Kit D dexamethasone sodium phosphate/pf Eligibility Available to patients with commercial prescription insurance coverage for HUMIRA who meet eligibility criteria. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs for example, Medicare including Part D, Medicare Advantage. 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. Sanofi-Aventis Patient Assistance Program Application; Click here to visit the program's web site.