In order to determine if you may be eligible for our programs, please review the important information below.
You must be a resident of the US, or have a Work Visa or Green Card.
You aren’t currently receiving prescription drug coverage under a private insurance or government program, or receiving any other assistance to help pay for medicine.
Your annual income* should be at or below:
- $35,000 for a single person
- $48,000 for a family of two
- $60,000 for a family of three
- $70,000 for a family of four
- $80,000 for a family of five
- *Income limits may be higher in Alaska and Hawaii
- Please note that the income eligibility criteria for some Specialty and/or Oncology Products may be different from the income levels listed above. Click here for more information.
IMPORTANT PROGRAM UPDATE:
Please note that there has been a change to the eligibility requirements for the AZ&Me™ Prescription Savings program for people with Medicare Part D. Beginning in 2017, in addition to meeting current eligibility criteria patients will also be required to spend 3% of total household income on prescription medicines through a Medicare Part D Prescription Drug Plan during 2017 in order to qualify for the program.
Medicare Part D patients will be required to submit a copy of their Medicare Part D prescription drug plan statement (Explanation of Benefits – EOB), pharmacy receipts or a summary document from a pharmacy indicating total spend on prescriptions in 2017; this total should be at least 3% of household income.
For questions regarding this change, please call 1-800-292-6363.
NOTE: Patients with Medicare Part B coverage may also be eligible. Please call 1-800-292-6363 for more information.
If you are a Medicare Part D Beneficiary:
- You aren’t eligible for or enrolled in Limited Income Subsidy (LIS) for Medicare Part D
If you have experienced a life changing event in the past year, and your financial documentation does not accurately reflect your current situation, we encourage you to apply for the AZ&Me Prescription Savings Program. You may still meet the criteria to enroll. Some examples of this type of event would be:
- Loss of employment
- Change in income
- Loss of, or change in, prescription drug coverage
- Change in household number