| CONTACT
INFO |
|
| 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
|
|
| 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. |
| |
Couple |
|
% FPL |
| |
Credit
for Dependents allowed |
| Medical expenses
can be deducted from reported income: |
No
|
| Social security requested on form: |
Yes |
| US citizenship/residency specified:
|
No |
|
|
APPLICATION |
|
| Attachments
Required: |
Prescription
Also include check, money order or credit card information.
|
Physician
License #
Required: |
Not Required
|
Prescriber
Signature
Allowed: |
Only patient needs to sign the application. |
Application
may be
faxed: |
No
|
Eligibility
determination
letter sent: |
None
|
|
| MEDICATION |
|
| Receives: |
Medication
|
| Shipped To: |
Provider
medications sent to wherever the patient requests it.
|
| Quantity in
Shipment: |
90-day supply
Some medications have 180-day supplies available. |
| Delivery Time: |
0-1 week
|
| Re-application
Policy: |
New application every 12 months
|
| 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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