As of January 2014, a patient enrolls in one of AstraZeneca's patient prescription assistance programs either by telephone or by filling out and sending in the application form available at AstraZeneca-US.com. To enroll by telephone, call 800-292-6363 on Monday through Friday between 8 a.m. and 6 p.m. Eastern Standard Time. Mail paper applications to the address listed on the company's website. Send faxed applications from the doctor's office of the patient, states AstraZeneca.
AstraZeneca's patient assistance programs are designed to assist people who experience difficulty paying for their AstraZeneca medications, according to AstraZeneca. In order to enroll in one of the programs, a person must provide AstraZeneca with documentation proving financial hardship. Forms of financial documentation that AstraZeneca accepts include the patient's most recently filed federal income tax return, income statements such as W2s and 1099s from all jobs the patient held within the past year, a Social Security Income Yearly Benefits Statement, or a letter from an unemployment office. The patient also provides his AstraZeneca prescriptions and either his Social Security Number or his green card or work visa number.
AstraZeneca offers three patient assistance programs, states AstraZeneca-US.com. Programs are available for people without insurance, those who are Medicare Part D beneficiaries and those who obtain their medications from health care facilities that participate in AstraZeneca's programs. The company's website provides complete lists of each program's eligibility requirements, enrollment procedures and other stipulations.