UNION PUBLIC LIBRARY
   Union, Iowa 50258    Phone: 641-486-5561
       E-mail unionlib@heartofiowa.net  

 Sunday              Closed  Wednesday       1-8  Saturday      10-5
  Monday                 1-6  Thursday          1-6
 Tuesday                 9-6  Friday                1-5


The Medicine Program





Can't Afford Your Prescription Medication?
Free Prescription Medicine is Available to those who Qualify.

  • If you do not have insurance or a government program that pays for your outpatient prescription medicines . . .

    If the high cost of your Medicine causes you a financial hardship . . .

    You may qualify to enroll in a privately sponsored program which provides. . .

MEDICINE at NO COST


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WHAT'S THE BEST KEPT SECRET of the drug business? You can get your medicine free of charge. Amid the growing furor about rising prescription costs, many patients and doctors aren't aware that the drug companies themselves give away millions of dollars worth of drugs each year. Most people do not know these programs exist. An organization known as The Medicine Program is here to help and cuts the red tape for thousands of eligible Americans. You can request a free brochure/application by calling 1-573-996-7300.



To begin the application process, PRINT THIS FORM, fill it out and mail it along with your processing fee of $5.00 for each medication requested to:
The Medicine Program, P.O. Box 515, Doniphan, MO 63935-0515.
Telephone: (573) 996-7300 

          Medication Information Form

Name of Patient:
Mailing Address:
City, State, Zip:
Telephone:
Date:
Please provide the following for each medication:
     Name of Medication
     Name and Address of Doctor

1.


2.


3.


4.


5.


6.


7.


8.


9.


10.


Comments:

 

If you are approved and enrolled, your medication will be sent to your doctor and he will dispense it to you. If the program's sponsor approves your application, you will receive your medication at no charge. If you wish to begin your application process at this time, simply mail to us the required items numbered one (1) through four (4). 

To be approved for enrollment, some of the primary requirements are:

The applicant has no insurance coverage for outpatient prescription drugs.

The applicant does not qualify for a government program which provides for prescription medication, e.g. Medicaid.

The applicant's income is at a level which causes a hardship when the patient is required to purchase the medication at retail. 

...to be accepted into the program, the applicant's income must fall within the limits established by his particular sponsor. The household income limit requirement varies with each program sponsor. 

Examples listed in the 2000 report outlining the sponsor's criteria for approval and enrollment, relate that individuals with family incomes ranging from below the national poverty level up to $50,000.00 annually can qualify. Those applicants normally qualifying at the highest income limits are generally AIDS, transplant or cancer patients in need of very expensive drugs. Decisions concerning which medications are provided and which individuals are accepted into the programs are made by the various program sponsors.

If you believe there is a possibility that you may qualify, and desire our assistance, please mail to us the following listed items, either by printing out, completing and mailing to us the above Program Application Form or by simply writing us a letter including:

  1. The name, address and phone number of the person taking the medication.
  2. The name of his/her medication(s).
  3. The name of your doctor who prescribes the medication.
  4. The Medicine Program requires a $5.00 processing fee for each medication requested. This fee is payable to The Medicine Program.

The processing fee should be mailed to us along with the above requested information about the patient's medication. The funds necessary to support this program and distribute these informational materials are provided by the $5.00 processing fees contributed by the applicants. 

The Medicine Program guarantees a full processing fee refund upon written request, to any applicant who receives no medication and is determined to be ineligible for assistance by all applicable manufacturers.  All refund requests must include a copy of each manufacturers letter indicating the applicant has been determined ineligible for assistance. Refund requests must be made within 90 days after original application is made to The Medicine Program. 

Immediately after receiving your information and fee, we will respond to you by return mail. One of the items you will receive from us will be a letter addressed to your doctor. This letter provides your doctor with information about this program and requests his/her cooperation. The doctor's letter will also provide an access number to your particular program sponsor. You should read, sign and forward the doctor's letter to him/her immediately after you have received and read it. 

Again, the first step you must take for us to be able to assist you in the application process, is for you to return to us the above items numbered one (1) through four (4). Upon receipt of these items we will immediately process your information and respond to you by return mail. 


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