How to Get Insurance to Pay for Lupron

Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.
Program 1 of 3. Scroll down to see them all.	Back | Print| Print All
Lupron Depot		View Coupon
myAbbVie Assist for Lupron Depot This program provides brand name medications at no or low cost
Provided by: AbbVie Inc.
PO Box 270 Somerville, NJ 08876 TEL: 800-222-6885 FAX: 866-483-1305	Languages Spoken: English, Spanish, Others By Translation Service Program Website
Program Applications and Forms
myAbbVie Assist for Lupron Depot Application
myAbbVie Assist for Lupron Depot Application (Spanish)
Medications
Lupron Depot injection (leuprolide acetate)
Eligibility Requirements
Insurance Status	Must be uninsured or underinsured
Those with Part D Eligible?	Varies
Income	At or below 600% of FPL
Diagnosis/Medical Criteria	Not applicable
US Residency Required?	Must be a US resident and treated by a US licensed healthcare provider
Application
Obtaining	Call or download
Receiving	Faxed or downloaded from website
Returning	Fax or mail from Doctor's office
Doctor's Action	Complete section, sign, attach required documents
Applicant's Action	Complete section, sign, attach required documents
Decision Communicated	Patient and Doctor are notified
Decision Timeframe	Not specified
Medication
Amount/Supply	As prescribed by Doctor
Sent To	Patient's home, unless otherwise noted
Delivery Time	Varies
Refill Process	Patient or Doctor must contact company
Limit	Varies
Re-application	Varies
Additional Information
Any patient who requires the medication and are in need should call the company. Eligibility determined on a case-by-case basis. Patients with prescription drug coverage may be eligible on exception basis. Contact program for details.
Updated October 18, 2021

Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.
Program 2 of 3. Scroll down to see them all.	Back | Print| Print All
Lupron Depot		View Coupon
HealthWell Foundation Copay Program This is a copay assistance program
Provided by: HealthWell Foundation
TEL: 800-675-8416	Languages Spoken: English, Others By Translation Service Program Website
Program Applications and Forms
HealthWell Foundation Copay Program Enrollment: Contact program
HealthWell Foundation COVID-19 Ancillary Costs: Contact program
Medications
Lupron Depot injection (leuprolide acetate)
Eligibility Requirements
Insurance Status	May have insurance
Those with Part D Eligible?	Yes
Income	Varies
Diagnosis/Medical Criteria	FDA Approved Diagnosis - See Program Website for Details
US Residency Required?	Must reside in the US
Application
Obtaining	Call or complete online
Receiving	Sent out or may be completed online
Returning	Mail
Doctor's Action	Complete section and sign
Applicant's Action	Complete section, sign, attach a copy of proof of income
Decision Communicated	Patient notified in writing
Decision Timeframe	3-5 business days
Medication
Amount/Supply	Not applicable
Sent To	Varies
Delivery Time	Not specified
Refill Process	Good for one year
Limit	Not specified
Re-application	New application every 12 months
Additional Information
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 insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease. Call for most recent medications as the list is subject to change.
Updated October 25, 2021

Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.
Program 3 of 3.	Back | Print| Print All
Lupron Depot		View Coupon
Patient Access Network Foundation (PAN) This is a copay assistance program
Provided by: Patient Access Network Foundation
TEL: 866-316-7263 FAX: 866-316-7261	Languages Spoken: English, Spanish, Others By Translation Service Program Website
Program Applications and Forms
Patient Access Network Foundation (PAN) Application: Contact program
Medications
Lupron Depot injection (leuprolide acetate)
Eligibility Requirements
Insurance Status	*See Additional Information section below
Those with Part D Eligible?	Determined case by case
Income	Between 400-500% of FPL
Diagnosis/Medical Criteria	FDA Approved Diagnosis - See Program Website for Details
US Residency Required?	Must reside and receive treatment in US
Application
Obtaining	Call or complete online
Receiving	Complete online or by phone
Returning	Complete online or by phone
Doctor's Action	Will be discussed with patient and Doctor after request is received
Applicant's Action	Call for information or inform doctor that he/she is in need
Decision Communicated	Patient and Doctor notified in writing
Decision Timeframe	Within 48 hours
Medication
Amount/Supply	Not applicable
Sent To	Patient sent card to be used at pharmacy
Delivery Time	Once approved; shipped same day
Refill Process	Patient presents voucher/card to pharmacy for each refill
Limit	None
Re-application	New application every 12 months
Additional Information
*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details.
Updated November 29, 2021

How to Get Insurance to Pay for Lupron

Source: https://www.needymeds.org/drug_list.taf?_function=name&drug_id=6938&name=Lupron%20Depot

Share this post