Program Details

JOHNSON & JOHNSON PATIENT ASSISTANCE FOUNDATION
Johnson & Johnson Patient Assistance Program

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CONTACT INFO
Address: Patient Assistance Program PO Box 0367
Chesterfield, MO 63006
Phone: 1-800-652-6227 Provider Phone:
Fax: 1-888-526-5168 Website: Program Website
ELIGIBILITY
Eligibility Info:
  • Patient must not have insurance of any kind, including government or private insurance and meet the eligibility income requirements for the medication.
  • Please call 1-800-652-6227 or visit Program website for specific FPL income requirements.
  •   Couple % FPL
    Income at or below: Not Published
    Medical expenses can be deducted from reported income: Not Published
    Social security requested on form: Yes
    US citizenship/residency specified: Yes
    APPLICATION
    Attachments Required: Financial
    Physician License #
    Required:
    Both DEA and State
    NPI
    Prescriber Signature
    Allowed:
    Physician
    Application may be
    faxed:
    Yes
    Eligibility determination
    letter sent:
    Both Provider and Patient
    MEDICATION
    Receives: Medication or Pharmacy card (see application for details)
    Shipped To: Either Provider and Patient
    Consult application for more details.
    Quantity in Shipment: Not Published
    Delivery Time: Not Published
    Re-application Policy: New application every 12 months
    New financial information every 12 months
    Refill Policy: Refills vary by medication
    Other Information:

    Last Updated: 01/10/2024


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