Assistance
Pharmacy Assistance is provided (for BCHC clients) through individual pharmaceutical companies in order to help those who financially qualify to receive free medicine from the manufacturer. This is determined through an application and evaluation of the previous year’s federal tax return 1040 or 1040EZ. Patients may print off applications from the pharmaceutical company’s websites (listed below) by looking for the patient assistance area. That form must be signed by our medical providers. Our assistance team will go over it and then send it in for a review. If you are accepted, in most cases you will receive four shipments containing three months of medicine. This program requires reapplying each year.
Pharmaceutical Companies
| A B C |
|
|
| Abbott Alcon Allergan All Kids Amgen ASAP, Inc. Astellas Astra Zeneca Aventis |
Bayer BD Bertek Biovail Boehringer Ingelheim Bristol-Myers Squibb Bridges to Access |
Centocor |
| D E F | ||
| Daiichi Sankyo, Inc. | Endo | Family Care Forest Fugisawa Healthcare, Inc. |
| G H I | ||
| Galderma Labs Glaxo Smith Kline |
Hill Dermatological, Inc. | ICN Ivax Labs |
| J K L | ||
| Janssen Johnson and Johnson |
Kid Cares | Lilly Cares Lederle |
| M N O | ||
| MedPointe Pharmaceuticals Merck Crossroads Merck: Vytorin and Zetia |
Nono Nordisk Novartis |
Ortho – McNeil |
| P Q R S | ||
| Partnership for Prescription Assistance Pfizer Pharmacia Proctor and Gamble |
RX Outreach | Schering Plough Corporation Sciele (1st Horizon) Suboxone |
| T U V W X Y Z | ||
| Takeda TAP Prevacid Program Taxes Teva Together RX Together RX – Medicare |
UCB Pharms | |
| Misc | ||
| 3M Pharmaceuticals |
New Patient Forms
Please download each of the new patient forms and fill them in preparation for your first visit.
Please fill out the Patient Update form should your information change.
| English | Spanish |
| Patient Update | Patient Update |