Frequently Asked Questions

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We’ve compiled a list of some of the most common questions you might have about our program. If you don’t find the answers that you need here, please contact us at 1-800-AZandMe (1-800-292-6363).

What is the AZ&Me Prescription Savings Program?

The AZ&Me Prescription Savings program for people without insurance provides AstraZeneca medicines at no cost to qualified patients. This prescription assistance program can help patients who do not have prescription drug coverage and who meet other eligibility criteria.

The AZ&Me Prescription Savings program for people with Medicare Part D provides AstraZeneca medicines at no cost to qualifying people who are enrolled in a Medicare Part D Prescription Drug Plan and have spent at least 3% of their household income on prescription medicines through a Medicare Part D Prescription Drug Plan during the current calendar year, but are having difficulty affording their AstraZeneca medicines.

NOTE: Patients with Medicare Part B coverage may also be eligible. Please call 1-800-292-6363 for more information.

What medications are covered in the AZ&Me Prescription Savings Program?

Most AstraZeneca medicines are included in the Program. Please visit our Prescription Product List for an up to date listing of the products covered by each program.

How much will I pay for my AstraZeneca medicine(s)?

The AZ&Me Prescription Savings program for people without insurance and The AZ&Me Prescription Savings program for people with Medicare Part D are both free, mail-based programs.

Does it cover generic medications?

The AZ&Me Prescription Savings Program only provides assistance with AstraZeneca brand name medications.

Is there a fee to enroll in the AZ&Me Prescription Savings Program?

There is no fee to enroll in the AZ&Me Prescription Savings Program.

How do I enroll in the AZ&Me Prescription Savings Program?

You can apply to the AZ&Me Prescription Savings Program in 3 ways:

  1. Call 1-800-AZandMe (1-800-292-6363) to speak with an assistance specialist

  2. Complete a hard-copy application and mail to:

    AZ&Me™ Prescription Savings Program
    P.O. Box 898898
    Somerville, NJ 08876

  3. Complete a hard-copy application and have your doctor’s office fax it to:

    For BRILINTA® (ticagrelor): 1-866-801-5480
    For SYNAGIS® (palivizumab) or IMFINZI™ (durvalumab): 1-855-686-8795
    For FASLODEX® (fulvestrant), IRESSA® (gefitinib), LYNPARZA® (olaparib), or TAGRISSO® (osimertinib): 1-877-239-0867
    For all other products: 1-800-961-8323

    NOTE: Faxed applications MUST be faxed from your doctor’s office in order for us to process your prescription.

What are the eligibility requirements for the AZ&Me™ Prescription Savings Program?

In order to determine if you may be eligible for our programs, please review the important information below.

You must be a legal US resident, or have a Work Visa or Green Card.

You must be without prescription drug coverage through private insurance or government programs.

You must not be eligible for Medicaid in your state of residence.

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.

If you are a Medicare Part D Beneficiary:

  • You must not be eligible for or enrolled in Limited Income Subsidy (LIS) for Medicare Part D
  • Your annual income* should be at or below the levels listed above.
  • You must have spent at least 3% of your total household income on prescription medicines through a Medicare Part D Prescription Plan during the current calendar year.
  • You must not be eligible for Medicaid in your state of residence.

NOTE: Patients with Medicare Part B coverage may also be eligible. Please call 1-800-292-6363 for more information.

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
  • Marriage
  • Change in household number

How do you define household income?

Your household income is the total combined pre-tax income for yourself, your spouse, and dependents. It is requested that you report either your monthly or yearly income.

Do I have to submit proof of income to the AZ&Me Prescription Savings Program?

Yes, proof of income is required. Acceptable documents include:

  • A copy of the most recent Federal Income Tax Returns for yourself, your spouse, and dependents
  • All income statements from jobs from the past year (W2 or 1099)
  • Social Security Income Yearly Benefits Statement (stating income you received from Social Security in the last year)
  • If your income is zero, a letter explaining your financial situation from a family member, healthcare provider, or yourself.

If you don’t have any of these documents, please call 1-800-AZandMe (1-800-292-6363).

What paperwork do I need to submit to the AZ&Me Prescription Savings Program?

For the AZ&Me™ Prescription Savings program for people without insurance
The following items will need to be submitted with your fully completed AZ&Me™ Prescription Savings Program application:
  • Your completed application, including the section completed by your physician
  • A copy of the most recent Federal Income Tax returns for yourself, spouse, and dependents (or other proof of income, please refer to above)
  • If your income is zero, a letter explaining your financial situation from a family member, healthcare provider, or yourself.
For the AZ&Me™ Prescription Savings program for people with Medicare Part D
The following items will need to be submitted with your fully completed AZ&Me™ Prescription Savings Program application:
  • Your completed application, including the section completed by your physician
  • A copy of the most recent Federal Income Tax returns for yourself, spouse, and dependents (or other proof of income, please refer to above)
  • If your income is zero, a letter explaining your financial situation from a family member, healthcare provider, or yourself.
  • A copy of the front and back of your Medicare RX Card.
  • A copy of your Medicare Part D Prescription Drug Plan statement (Explanation of Benefits-EOB), pharmacy receipts or a summary document from your pharmacy indicating what you have spent for prescriptions in the current calendar year.

For SYNAGIS® (palivizumab) please refer to the checklist printed on the application for that product.

Where do I send my AZ&Me Prescription Savings Program application?

AZ&Me™ Prescription Savings Program
P.O. Box 898
Somerville, NJ 08876

Or

Fax*:
For BRILINTA® (ticagrelor): 1-866-801-5480
For SYNAGIS® (palivizumab) or IMFINZI™ (durvalumab): 1-855-686-8795
For FASLODEX® (fulvestrant), IRESSA® (gefitinib), LYNPARZA® (olaparib), or TAGRISSO® (osimertinib): 1-877-239-0867
For all other products: 1-800-961-8323

*PLEASE NOTE: Faxed applications MUST be sent from your doctor’s office in order for us to process your prescription.

How long am I enrolled in the AZ&Me Prescription Savings Program?

For the AZ&Me Prescription Savings program for people without insurance
As long as you meet all eligibility requirements and have submitted your appropriate paperwork you may be enrolled in the Program for up to 12 months. You may be able to re-enroll if you continue to meet the Program eligibility criteria.

For the AZ&Me Prescription Savings program for people with Medicare Part D
As long as you meet all eligibility requirements and have submitted your appropriate paperwork you may be enrolled in the Program for up to 12 months. You may be able to re-enroll if you continue to meet the Program eligibility criteria.

For SYNAGIS® (palivizumab), enrollment is up to 12 months, running from July 1 - June 30.

How do I submit my prescription?

Since a valid prescription for AstraZeneca medicine is required in order to qualify for the program, your healthcare provider will need to be involved with your enrollment. The AZ&Me Prescription Savings Program application includes a section for your healthcare provider to complete, including your prescription information. As long as this section of the application is completed correctly, a separate prescription form is not necessary.

How many days of medication can I get from the AZ&Me Prescription Savings Program?

The quantity dispensed is determined by the quantity indicated by your physician on the prescription, in addition to the program’s pharmacy guidelines for each medicine. The prescription may indicate up to a 90 day supply per fill.

When can I refill my prescription?

Refills will be allowed after you have taken 2/3 of your prescription. This percentage is calculated from the last date of fill.

For Prescription Refills, call 1-800-292-6363. Once you are enrolled in the Program, your prescriptions can easily be refilled by calling our automated phone line 24 hours a day, 7 days a week.

How long will it take to get my medicine from the AZ&Me Prescription Savings Program?

It can take 1-2 weeks to get your first shipment of medicine. Refills typically are received within 5-7 business days.

Why is AstraZeneca offering the AZ&Me Prescription Savings Program?

AstraZeneca recognizes that some people may experience difficulty affording their AstraZeneca medicines. The AZ&Me Prescription Savings Program fits with AstraZeneca’s long history of helping to ensure that those who use AstraZeneca medicines are able to access them when they need them.

When did the AZ&Me Prescription Savings Program start?

AstraZeneca has offered patient assistance programs for over 35 years.

Can I withdraw from the program?

AZ&Me Prescription Savings Program enrollees may voluntarily withdraw from the program at any time by calling 1-800-AZ&Me (1-800-292-6363).