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We believe strongly in being able to provide our patients the medication that best suits their individual, personalized treatment plan. However, some medications can be cost-prohibitive without financial support. Fortunately, many pharmaceutical companies provide patient assistance programs if the copay cards do not help enough.
For any NEW patient assistance program applications or renewals, please make sure to send our team a message on SpruceHealth. Please send your application with all your information entirely completed and any necessary attachments. Once we have reviewed and completed our portion, we will forward it to the office to be compiled and they will fax the completed form directly to the program and send you a confirmation.
For RENEWALS, please make sure you are proactive in downloading and filling out your forms before your program expires. This may happen on the calendar year or a year after you were approved. Sometimes, the renewal email goes into your spam folder. Please make sure you know your renewal date and set a reminder in your calendar to complete your form at least a month in advance before it expires.
Once your initial application or renewal paperwork has been completed you can submit it to our office by faxing your form directly to our team at (321) 616-8126, emailing a scanned PDF copy to office@mindfulpsychiatry.sprucecare.com, or attaching a PDF copy to a message in Spruce.
Please allow 1 week for the completion of these forms. If it has been over a week and you have not received confirmation, please reach out to make sure we have received your form.
Eligibility
Many patients are eligible for patient assistance programs if their family income is 5x the poverty income or less ( https://aspe.hhs.gov/poverty-guidelines ).
i.e.
a family of 1 would be eligible if they make $72,900 or less
a family of 2 can make $98,600
a family of 3 can make $124,300
a family of 4 can make $150,000
Extra Help Medicare Program
The programs below don't work if you have Medicare. But there is the Medicare Extra Help Program. Follow the link below to read more information and look at how to apply:
Phone Number: 1-800-633-4227
Website: https://www.medicare.gov/basics/costs/help/drug-costs
Income Eligibility
Individual - Income: $21,870 - Resources: $16,600
Married couple - Income: $29,580 - Resources: $33,240
Apply Online: click here
Help at Hand Program by Takeda
Phone Number: 1-800-830-9159
Website: https://www.takeda.com/en-us/corporate-responsibility/patient-assistance/
*** NO LONGER COVERING Vyvanse or Mydayis as of December 31st, 2023 - as these are now generic ***
Download PDF form below:
Otsuka Patient Assistance Foundation
Phone Number: 1-855-727-6274
Website: https://www.otsukapatientassistance.com/
Completed entirely online - Provider must initiate - send message to our team if you wish for us to start this process
If you have trouble with e-Consent, you may fill it out here
Or download the Patient Consent below:
Abbvie Program by AllerganPhone Number: 1-800-222-6885 Website: https://www.abbvie.com/patients/patient-support/patient-assistance.html
STEPS to Complete:
1. Open website: https://www.abbvie.com/patients/patient-support/patient-assistance/eligibility-criteria.html
2. Select your medication from the list online and download the form
3. Complete form
4. send completed copy to our office (you may securely send it by attaching an image or pdf to your Spruce account)
Sunovion Patient Assistance Program
Phone Number: 1-877-850-0819
Website: https://www.sunovionsupport.com/
Or download PDF below:
Intracellular Therapies Patient Assistance Program
Phone Number: 1-888-252-4824
Website: https://www.intracellulartherapies.com/patient-assistance/
Caplyta Household Income levels (less than the other programs)
Number of People l Annual Household Income
1 $38,280
2 $51,720
3 $65,160
4 $78,600
5 $92,040
6 $105,480
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