Arch Foundation Patient Assistance Program for Mirena

Summary

Bayer HealthCare Pharmaceuticals was founded by Friedrich Bayer and Johann Friedrich Weskott in Barmen, Germany, 1863. Bayer HealthCare Pharmaceuticals developed Aspirin, one of the most common and widely used drugs to date, along with several other's over the last century. As a worldwide leader in the pharmaceuticals industry, Bayer HealthCare Pharmaceuticals provides physicians with the tools they need to diagnose, prevent, and treat diseases in their patients. Their goal is to develop treatments and therapies for the overall improvement of human health. After acquiring Berle's parent company, Schering AG, Bayer AG has changed their name to Bayer HealthCare Pharmaceuticals to encompass both companies in one.

The ARCH Foundation is a not-for-profit foundation who specifically provides the patient assistance program for the Mirena contraceptive.

Mirena is an estrogen-free intrauterine contraceptive launched by Berlex Laboratories Inc. in 2003. Mirena has been approved by the FDA as an alternate form of contraception. Mirena is placed into the uterus by your physician.

Eligibility

ARCH Foundation Patient Assistance Program For Mirena, a patient assistance program provided by The ARCH Foundation , offers Mirena at no cost to those who are eligible for the program. Eligibility is based off of the following requirements:

You must be a citizen of the United States or its Territories.

You must not be covered by any private, public, or Medicare Part D prescription coverage programs.

You must meet an undisclosed income guideline.

The device must be sent to the physicians office.

SOURCE: 2008 Poverty Chart

Family Size

300%

250%

200%

150%

133%

100%

$32,490

$27,075

$21,660

$16,245

$14,404

$10,830

$43,710

$36,425

$29,140

$21,855

$19,378

$14,570

$54,930

$45,775

$36,620

$27,465

$24,352

$18,310

$66,150

$55,125

$44,100

$33,075

$29,327

$22,050

$77,370

$64,475

$51,580

$38,685

$34,301

$25,790

$88,590

$73,825

$59,060

$44,295

$39,275

$29,530

$99,810

$83,175

$66,540

$49,905

$44,249

$33,270

$111,030

$92,525

$74,020

$55,515

$49,223

$37,010

Each Additional Family Member

$11,220

$9,350

$7,480

$5,610

$4,974

$3,740

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Arch Foundation program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

Other Tips

If you have any questions please call the Arch Foundation program directly.
Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in.
Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don't run out of medication.
Do not write messy on your forms as this will delay any response.
Call and write thank you notes to AAI Pharma Inc. program. Without their help millions of people will be without medication.