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
Click Here
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 $24,280
Family of Two
Below $32,920
Family of Three
Below $41,560
Family of Four
Below $50,200
Family of Five
Below $58,840
Family of Six
Below $67,480
Family of Seven
Below $76,120
Family of Eight
Below $84,760
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
2018 Federal Poverty Level