Aristada Patient Assistance Program

Funded

About

The Aristada Patient Assistance Program is designed to support uninsured or 'functionally' uninsured patients by providing up to six months of medication assistance for Aristada and Aristada Initio at no cost. This program is a vital resource for those prescribed these medications for on-label use, ensuring access to treatment through a simple application process. With Aristada Patient Assistance Program, eligible patients can receive their medication directly through a US licensed healthcare provider, offering a streamlined and supportive experience.

Insurance requirements: Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Eligible uninsured or “functionally” uninsured patients with a valid prescription can receive up to 6 months of assistance at no cost

•Prescription must be by a US licensed healthcare provider

•Shipment must be delivered to a licensed healthcare provider at a location within the 50 states (excluding PR and US Territories)

•Completed form and valid prescription must be faxed to: 18444647171; incomplete fields will delay processing

•For more information patients must call 1866ARISTADA (18662747823), 9am–8pm (ET)

Enrollment Forms

Enrollment Form