Carnitor Drug Assistance Program
Sigma-Tau Pharmaceut
Contact Information
NORD
55 Kenosia Avenue
Danbury, CT 06813-1968
1-(800) 675-8415 (phone)
1-(203) 798-2964 (fax)
NORD
55 Kenosia Avenue
Danbury, CT 06813-1968
1-(800) 675-8415 (phone)
1-(203) 798-2964 (fax)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
- Click here to visit the program's web site.
- Carnitor
Eligibility:
All applicants must be citizens or permanent residents of the United States. Eligibility is determined by medical and financial criteria and applied to a cost-share formula. A patient applying for eligibility under the CDA Program must first demonstrate having a legal prescription for Carnitor. Second, the applicant must prove financial need above and beyond the availability of federal and state funds, private insurance or family resources. If an applicant is a minor or an adult dependent, NORD may request financial information of family members or guardians before determining the applicant's eligibility. Applications must be submitted annually to determine continued medical and financial eligibility. Acceptance into the program at any time does not guarantee ongoing eligibility, nor does it mean that applicants are entitled to or will be granted benefits at a later time.
All applicants must be citizens or permanent residents of the United States. Eligibility is determined by medical and financial criteria and applied to a cost-share formula. A patient applying for eligibility under the CDA Program must first demonstrate having a legal prescription for Carnitor. Second, the applicant must prove financial need above and beyond the availability of federal and state funds, private insurance or family resources. If an applicant is a minor or an adult dependent, NORD may request financial information of family members or guardians before determining the applicant's eligibility. Applications must be submitted annually to determine continued medical and financial eligibility. Acceptance into the program at any time does not guarantee ongoing eligibility, nor does it mean that applicants are entitled to or will be granted benefits at a later time.
Other Information:
Generally, a patient over 18 years of age may submit his or her own application. If the patient is an adult under the guardianship of another adult, or is a minor, the patient and his/her guardian or parents must jointly submit an application. Applications are reviewed throughout the year. One application per patient, per year, will be accepted. In the event of a significant change in a patient's circumstances, a second application may be considered.
Generally, a patient over 18 years of age may submit his or her own application. If the patient is an adult under the guardianship of another adult, or is a minor, the patient and his/her guardian or parents must jointly submit an application. Applications are reviewed throughout the year. One application per patient, per year, will be accepted. In the event of a significant change in a patient's circumstances, a second application may be considered.
Product(s) covered by program:
