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| Program Contact Info / Application Submission |
| Program | Cenestin Patient Assistance Program | | Company | DuraMed | | Form | Download PDF | | Address | 250 Phillips Blvd, Ste 250, Ewing, NJ 08618 | | Phone | 800-425-3122 | | Fax | 800-685-2577 | | |
| Program Details |
| Details | Up to a 90-day supply is sent to the doctor's office. The patient or doctor must contact the company for refills. Every year a new application is needed.
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| Program Requirements |
| Information | The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income | | Details | Proof of Income required
| | Other Requirements | Patients with | | |
| Delivery of Medication |
| Ship Time | 2 Weeks | | Delivery Options | Can NOT be delivered directly to the patient
Can be delivered directly to the doctor
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| Application Process |
| App Process | Anyone requesting assistance can call to request a faxed application or download it from the website. The application is sent to the doctor's office. The completed application must be faxed or mailed from the doctor's office. The doctor is notified of acceptance or denial. Allow 2 weeks for processing and delivery of medication.
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| Eligibility |
| Eligibility | The patient must have no prescription coverage for the requested medication and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. If a patient is eligible for Medicare Part D but does not enroll then s/he may still be eligible for this program. But if a patient enrolls in Part D, and it doesn't cover Cenestin then s/he is not eligible for this program.
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| Other Medications |
Other
Medications
available in
this program | |
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