Prescription Drug Assistance
A vision of healthy people, living in healthy communities.
Are you without prescription drug coverage?
Are you unable to purchase your medications?

Let us help!
Our program helps those who find it difficult to afford
their costly medicines gain access to them through
Patient Assistance Programs.

How does the Program Work?

You can call our office 573-624-1607 for
an Enrollment Packet to be mailed to you or you
may download the enrollment forms and  
instructions by clicking on the link below.
Once you have reviewed, printed and completed the
necessary forms you can mail them and required
documents to our office.  
Please do not fax completed applications.

ENROLLMENT PACKET
Upon approval, an application for your medication(s) will
be sent to you.  Please sign and date the application
and mail it back to our office.

We will attach other essential documents and send your
application to your doctor.  When the doctor returns
the application to our office, other necessary documents
will be attached and the paperwork will be finalized
and sent to the pharmaceutical company.

The medicine will be delivered according to the
companies' guidelines either to your home or to your
doctors' office for patient pickup.

Most applications we submit are for a 90-day supply of
medication.
_________________________________

Regional Healthcare Foundation
Prescription Drug Assistance (PDA)  Program
215 W. Grant
Dexter, MO 63841
573-624-1607
You might qualify for
Free Medications...

  1. You do not have prescription
    drug insurance coverage or
    you are underinsured.
  2. You meet the pharmaceutical
    company's income guidelines
  3. You are a U.S. Resident
Individual
Below $24,120
Family of Two
Below $32,480
Family of Three
Below $40,840
Family of Four
Below $49,200
Family of Five
Below $57,560
Family of Six
Below $65,920
Family of Seven
Below $74,280
Family of Eight
Below $82,640
Mininum Financial Guidelines  
*
Some companies have higher income
guidelines
Financial guidelines may be greater
or less than those specified above,
due to the guidelines of the drug
companies.
Do not hesitate to contact our office to
verify eligibility
.

Guidelines are based on the Federal
Poverty Level 2017