AZ&Me(tm) Prescription Savings program for people without insurance

Summary

AstraZeneca is a pharmaceutical company that was founded in 1999 after the merger of Astra AB and Zeneca Group PLC. Since the establishment of the company, AstraZeneca has provided solutions for cancer, heart disease, mental illness, gastrointestinal disorders, infections, and respiratory conditions. As they continue to expand, they have focused more effort on improving overall healthcare and patient treatment. AstraZeneca has their major research and development sites located in the United States, United Kingdom, Sweden, and India. As a leader in the pharmaceutical industry, AstraZeneca plans to expand even further as is evident by their acquisition of Cambridge Antibody Technology and MedImmune.

Eligibility

Patient applications are evaluated on a case-by-case basis by the AZ&Me Prescription Savings Program. Eligibility is based on income level and the absence of prescription drug coverage (uninsured) through private insurance, federal health care programs, or state patient assistance programs including the Limited-Income Subsidy. Annual income at or below $30,000 for an individual; $40,000 for a couple; $50,000 for family of three or $60,000 for a family of four. The program requires a Social Security #, work visa number or green card number and appropriate income documentation. Enrollment in the program is for 12 months, reapplication is at month 10.

Patients approved into the AZ&Me Prescription Savings program for people without insurance will receive an acceptance letter and should receive their shipment of product within 1-2 weeks. Medicines are sent directly to the patientÃ¢â‚¬â„¢s home or other designated location with the exception of Seroquel, Faslodex, and Zoladex. Patients denied to the program will receive a denial letter if they do not meet the eligibility guidelines for the program.

Other Information:

If requesting Arimidex, Casodex, Faslodex or Zoladex, dial the AstraZeneca Cancer Support Network at 866-992-9276 to obtain additional information about completing your application.

- Your income must be less than or equal to 300% of the Federal Poverty Guideline for the size of your household (see chart below).

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 AstraZeneca Pharmaceuticals 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 AstraZeneca Pharmaceuticals 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.