| Pharmaceutical Company | Abbott Laboratories, Pharmaceutical Products Division(Second Web Site) |
| Program Address | Dep't 31C, AP-30 200 Abbott Park Rd. Abbott Park, IL 60064 |
| Toll Free Phone Number | 800-441-4987 #1 |
| Alternate Phone Number | None |
| Fax Number | None |
| Guidelines and Notes | Call between 8:30 A.M. and 4:30 P.M. central time. Call thefirst number to enroll patients; the second to reach the department that makes eligibility decisions. The program is for low income patients without prescription benefits. The applicant's income must fall between 100-200% of the federal poverty guidelines. If the applicant doesn't fall within these guidelines, thena letter of rejection from Medicaid is required. |
| Initiating Enrollment | The doctor's office must call for the application. Basic information is required when the application is requested. It should arrive in about two weeks. |
| Health Provider's Role | The doctor completes and signs the form. No prescription is needed. |
| Patient's Role | Detailed financial and insurance information is required. Proof of income may be requested. |
| How Dispensed | The medicine is sent to the doctor's office. |
| Amount Dispensed | A 30 days supply is sent, followed by three 90 day supplies. The patient calls when the supply is getting low. |
| Estimated Response Time | Not specified |
| Refills | After 10-12 months, call and request a re-application form. |
| Limit | Not specified. |