|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.
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
Regional Healthcare Foundation
Prescription Drug Assistance (PDA) Program
215 W. Grant
Dexter, MO 63841
|You might qualify for
|Mininum Financial Guidelines
*Some companies have higher income
|Financial guidelines may be greater
or less than those specified above,
due to the guidelines of the drug
Do not hesitate to contact our office to
Guidelines are based on the Federal
Poverty Level 2017