lets you do what you do best: care for patients.
our help, you and your staff can spend more time with your patients. Chronic
care medications, when taken as prescribed, lower medical costs for everyone
and improve the quality of life and health of patients.
click on "Locations" to find the program
closest to you.
refer a patient, physician/prescriber must complete and
submit a Referral Form to MEDBANK.
Form (MS Word format)
companies that have patient assistance programs
and patient complete a referral form, including a list of
the patient's prescribed medications (Brand Name Only)
provides proof of income and insurance information to
to verify eligibility.
must sign a consent/authorization form.
Program representative identifies Patient Assistance Programs
for the patient, completes applications and where required
obtains written prescriptions from physician - and patient
and/or physician signatures.
pharmaceutical companies will ship a 90-day supply to the
notifies the MEDBANK Program representative when medications
are received and the MEDBANK Program representative repeats
Security number or green card
of income (tax return, pay stubs)
of benefits (Award) letter from Social Security
of medications (Brand Name medications only)
of assets (home, savings, checking, CD's, IRA's, etc.)
Initially the process can take
between 2-4 weeks depending on whether the drugs come from our
pharmacy or the drug company. Talk
with your physician or health care professional
about what to do until your medication arrives.
additional questions please call us or read the
Frequently Asked Questions section.
Patient Assistance Program Eligibility Criteria and Medicare Part D