Upsher-Smith Patient Assistance Program - Patient Assistance Programs

Summary

Upsher-Smith was founded in 1919 by F. A. Upsher-Smith when he started processing digitalis drug products which treated patients afflicted with congestive heart failure. Through the course of his research, he was able to craft a stable active form of digitalis. And it was from there that the company blossomed. In addition to pursuing the field of cardiology, Upsher-Smith is also involved in the dermatological field, as well as womenâ€™s health. More recently, the focus has been in to their foray on neurological products which treat epilepsy and the accompanying seizures, as well as Parkinsonâ€™s disease.

Eligibility

Upsher-Smith Patient Assistance Program, a patient assistance program provided by Upsher-Smith, offers two prescriptions of the medications listed to the right at no cost to those who are eligible for the program. Eligibility is based off of the following requirements:

- You must not be covered by private or public health insurance.

- You must meet an undisclosed income guideline.

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

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

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 Upsher-Smith 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 Upsher-Smith 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.