Venofer Patient Assistance Program (free-standing dialysis centers only)
Fresenius Medical Ca
Contact Information
Venofer Patient Assistance Program (free-standing dialysis centers only)
P.O. Box 18370
Louisville, KY 40261
1-(877) 694-7661 (phone)
1-(866) 496-8638 (fax)
1-877-MYIRON1 (vanity_phone)
Venofer Patient Assistance Program (free-standing dialysis centers only)
P.O. Box 18370
Louisville, KY 40261
1-(877) 694-7661 (phone)
1-(866) 496-8638 (fax)
1-877-MYIRON1 (vanity_phone)
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.
Eligibility:
The patient must have no prescription coverage and meet income guidelines that are not disclosed. The patient must also have a diagnosis of ESRD and be on dialysis. The patient must also be a US citizen or legal resident. The application will be faxed or mailed out. The completed application must be faxed or mailed back. The doctor is notified in writing of acceptance or denial. The decision is usually made within 72 hours. The doctor must fill out the physician section and sign the application. The patient must also fill out a section, sign the application and attach proof of income.
The patient must have no prescription coverage and meet income guidelines that are not disclosed. The patient must also have a diagnosis of ESRD and be on dialysis. The patient must also be a US citizen or legal resident. The application will be faxed or mailed out. The completed application must be faxed or mailed back. The doctor is notified in writing of acceptance or denial. The decision is usually made within 72 hours. The doctor must fill out the physician section and sign the application. The patient must also fill out a section, sign the application and attach proof of income.
Other Information:
After PAP application approval, the provider must return the Venofer® Product Order form for replacement product. The provider must return a new product order form to re-order within the 12 month enrollment period. After 12 months, a new enrollment period begins and new application is required.
After PAP application approval, the provider must return the Venofer® Product Order form for replacement product. The provider must return a new product order form to re-order within the 12 month enrollment period. After 12 months, a new enrollment period begins and new application is required.
Product(s) covered by program:
- Venofer®
