| Drug Information | ||||||||||||||||||||||||||
| Drug | Tilade Inhaler | |||||||||||||||||||||||||
| Program Contact Info / Application Submission | ||||||||||||||||||||||||||
| Program | King Pharmaceuticals, Inc. PAP | |||||||||||||||||||||||||
| Company | King Kare | |||||||||||||||||||||||||
| Form | Download PDF | |||||||||||||||||||||||||
| Address | PO Box 608 Somerville, NJ 08876 | |||||||||||||||||||||||||
| Phone | 866-734-7366 | |||||||||||||||||||||||||
| Program Details | ||||||||||||||||||||||||||
| Details | Up to a 90-day supply is sent to the doctor's office. A new application is needed for each refill. Once a year a new application with financial documentation is needed. | |||||||||||||||||||||||||
| Program Requirements | ||||||||||||||||||||||||||
| Information | The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section, sign the application and attach proof of income. | |||||||||||||||||||||||||
| Details | Proof of Income NOT required | |||||||||||||||||||||||||
| Delivery of Medication | ||||||||||||||||||||||||||
| Ship Time | 4 weeks | |||||||||||||||||||||||||
| Delivery Options | Can NOT be delivered directly to the patient | |||||||||||||||||||||||||
| Application Process | ||||||||||||||||||||||||||
| App Process | Anyone with the patient's and the doctor's information can call. The application is faxed to the doctor's office. The completed application must be mailed back. If the patient is denied, both patient and doctor are notified. The estimated timeline is 2-4 business days. The medication is usually shipped within 7-10 business days. | |||||||||||||||||||||||||
| Eligibility | ||||||||||||||||||||||||||
| Eligibility | The patient must have no prescription coverage for any medications and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. See the application for specific information about the income guidelines. | |||||||||||||||||||||||||
| Other Medications | ||||||||||||||||||||||||||
| Other Medications available in this program |
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