Takeda Help At Hand Patient Assistance Program
Funded
About
The Takeda Help At Hand Patient Assistance Program provides free Trintellix to eligible patients who are uninsured or underinsured and demonstrate financial need. Patients must meet income requirements based on federal poverty guidelines (up to 500% FPL). Applications must be submitted by a U.S.-licensed prescriber.
Insurance requirements: Uninsured, Underinsured
Enrollment Forms
Apply for Takeda Help at Hand
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: Yes
•Activation Required: No
Program Details
•Provides free Trintellix to eligible uninsured or underinsured patients
•Must be prescribed Trintellix by a U.S.licensed physician
•Must reside in the United States or a U.S. territory; proof of citizenship is not required
•Income eligibility: up to 500% of the Federal Poverty Level (FPL); income levels change annually
•Medicare Part D patients below 150% FPL must apply for and be denied Extra Help before applying
•Doctor must submit the application on the patient behalf
•Application fax: 18004970928 | Mail: P.O. Box 5727, Louisville, KY 402550727
•Review process: approximately 35 business days after submission
•Annual renewal required
•No fee charged to patients
Enrollment Forms
Apply for Takeda Help at Hand