CONTACT
INFO |
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Address: |
RxOutreach PO Box 66536
St. Louis, MO 63166-6536 |
Phone: |
1-888-796-1234 |
Provider Phone: |
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Fax: |
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Website: |
Program Website |
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ELIGIBILITY
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Eligibility
Info: |
An individual of any age can participate in the program, as long as the program's financial guidelines are met.
COVID-19 Update:Rx Outreach has expanded the eligibility guidelines beyond 400% FPL to include people affected by COVID-19. |
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Couple |
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% FPL |
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Credit
for Dependents allowed |
Medical expenses
can be deducted from reported income: |
No
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Social security requested on form: |
Yes |
US citizenship/residency specified:
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No |
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APPLICATION |
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Attachments
Required: |
Prescription
Also include check, money order or credit card information.
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Physician
License #
Required: |
Not Required
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Prescriber
Signature
Allowed: |
Only patient needs to sign the application. |
Application
may be
faxed: |
No
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Eligibility
determination
letter sent: |
None
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MEDICATION |
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Receives: |
Medication
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Shipped To: |
Provider
medications sent to wherever the patient requests it.
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Quantity in
Shipment: |
90-day supply
Some medications have 180-day supplies available. |
Delivery Time: |
0-1 week
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Re-application
Policy: |
New application every 12 months
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Refill Policy: |
Prescription can be written with refills for up to one year. |
Other Information: |
A separate application must be submitted for each household member applying for medication. Only one application is required per patient; however, a doctor's prescription for each medication must accompany the application.
Administrative fees for medications vary. Please refer to the application for the appropriate fees. |
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