Rx OUTREACH

Contact info

Phone

1-888-796-1234

Mailing address

RxOutreachPO Box 66536St. Louis, MO 63166-6536

Website

Program website (opens in a new tab)

Eligibility

Income limit, single

Not published

Income limit, couple

Not published

Dependents

Income limit goes up for each dependent

Medical expenses can be deducted

No

Social Security number asked for

Yes

US citizenship or residency required

No

Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).

Application process

Documents to attach

• Prescription
• Also include check, money order or credit card information.

Prescriber license number

Not required

Who can sign

Only patient needs to sign the application.

Application can be faxed

No

Decision letter sent to

No letter is sent

Getting the medication

Patient receives

Medication

Shipped to

Provider. medications sent to wherever the patient requests it.

Supply per shipment

90-day supply Some medications have 180-day supplies available.

Time to first delivery

0–2 weeks

Refills

Prescription can be written with refills for up to one year.

Staying enrolled

• New application every 12 months

Medications covered

• Abilify (aripiprazole)
• Allegra OTC (fexofenadine OTC tablet)
• Ampyra Tablet (dalfampridine)
• Aygestin (norethindrone acetate tablet)
• Baraclude (entecavir)
• Celebrex (celecoxib)
• Colazal (balsalazide)
• Cytra-K (potassium citrate)
• Effexor XR (venlafaxine)
• Epinephrine auto injector .15mg (epinephrine auto injector)
• EpiPen (epinephrine)
• EpiPen Jr (epinephrine)
• Famvir (famciclovir tablet)
• Flexeril (Cyclobenzaprine)
• Klor-Con 8mEQ (potassium chloride ER tablet)
• Klor-Con M10 (potassium chloride ER tablet)
• Nardil (phenelzine sulfate)
• Symmetrel (amantadine)
• Tegretol XR (carbamazepine extended release)
• Zonegran (zonisamide)
• Accolate (zafirlukast)generic
• Accupril (quinapril HCI)generic
• Accuretic (quinapril/HCTZ tablet)generic
• Aciphex (rabeprazole sodium)generic
• Aclovate (alclometasone dipropionate cream)generic
• Actonel (risedronate sodium tablet)generic
• Actos (pioglitazone hydrochloride)generic
• Adalat cc (nifedipine CR tablet)generic
• Adderall XR (dextroamphetamine-amphetamine ER capsule)generic
• Alaway OTC (ketotifen fumerate OTC solution)generic
• Albuterol Inhalation Solution (albuterol inhalation solution)generic
• Aldactazide (spironolactone and hydrochlorothiazide)generic
• Aldactone (spironolactone)generic
• Altace (ramipril)generic
• Amaryl (glimepiride)generic
• Ambien (Zolpidem)generic
• Amoxapine tablet (amoxapine tablet)generic
• Anafranil (clomipramine hcl)generic
• Anaprox DS (naproxen sodium tablet)generic
• AndroGel (testosterone gel)generic
• Antivert (meclizine HCI)generic
• Aricept (donepezil HCI)generic
• Arimidex (anastrazole)generic
• Artificial Tears 1.4% drops (OTC) (artificial tears 1.4% drops (OTC))generic
• Aspirin EC Tablet (OTC) (aspirin EC tablet (OTC))generic
• Astelin (Azelastine nasal spray)generic
• Astepro (azelastine)generic
• Atacand (candesartan cilextil)generic
• Atacand HCT (candesartan cilexetil-hydrochlorothiazide)generic
• Ativan (lorazepam tablet)generic
• Avalide (irbesartan-hydrochlorothiazide)generic
• Avapro (irbesartan)generic
• Azilect (rasagiline tablets)generic
• Azulfidine (sulfasalazine)generic
• Azulfidine EN-Tabs (sulfasalazine, USP)generic
• Bactrim DS (sulfamethoxazole/trimethoprim DS tablet)generic
• Banzel (rufinamide)generic
• Banzel Oral Suspension 40mg/ml (rufinamide)generic
• Bentyl (dicyclomine capsule)generic
• Bentyl (dicyclomine tablet)generic
• Benzonatate capsule (benzonatate capsule)generic
• Benztropine tablet (benztropine tablet)generic
• Brimonidine Tartrate 0.2% Solution (brimonidine tartrate)generic
• Bromocriptine tablet (bromocriptine tablet)generic
• Buspar (buspirone tablet)generic
• Calan (verapamil HCl)generic
• Calan-SR (verapamil SR tablet)generic
• Capoten (captopril tablet)generic
• Capsaicin Cream, 0.035% (OTC) (capsaicin cream, 0.035% (OTC))generic
• Carafate (sucralfate)generic
• Cardizem CD (diltiazem hcl cd)generic
• Cardura (doxazosin mesylate)generic
• Casodex (bicalutamide)generic
• Catapres (clonidine HCL tablets)generic
• Catapres TTS -3 (clonidine patch)generic
• Celexa (citalopram tablet)generic
• CellCept (mycophenolate mofetil)generic
• Chlordiazepoxide capsule (chlordiazepoxide capsule)generic
• Chlorpromazine HCL (chlorpromazine HCL)generic
• Chlorthalidone tablet (chlorthalidone tablet)generic
• Claritin OTC (loratadine OTC tablet)generic
• Cleocin (clindamycin phosphate)generic
• Colestid (colestipol hcl)generic
• Cordarone (amiodarone tablet)generic
• Coreg tablets (carvedilol)generic
• Cozaar (losartan potassium)generic
• Crestor (rosuvastatin calcium)generic
• Cytomel (liothyronine sodium)generic
• Dacogen (decitabine)generic
• Depakene (valproic acid)generic
• Depakote (Divalproex DR tablet)generic
• Depo-Testosterone (testosterone cypionate)generic
• Desyrel (trazodone tablet)generic
• Detrol (tolterodine tartrate tablet)generic
• Dextroamphetamine sulfate ER capsule (dextroamphetamine sulfate ER capsule)generic
• Dextroamphetamine-Amphetamine tablet (dextroamphetamine-amphetamine tablet)generic
• Dibenzyline capsule (phenoxybenzamine)generic
• Diflucan (fluconazole)generic
• Dilacor XR (diltiazem ER capsule)generic
• Dilantin (phenytoin sodium capsule)generic
• Diovan (valsartan hydrochloride)generic
• Diovan HCT (valsartan hydrochlorothiazide)generic
• Diprolene Cream (augmented betamethasone dipropionate)generic
• Ditropan (oxybutynin tablet)generic
• Donnatal Elixir (Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide)generic
• Donnatal Tablet (Belladonna Alkaloids with Phenobarbital)generic
• Doxepin capsule (doxepin capsule)generic
• DuoNeb (Ipratropium/Albuterol Inhalation Solution)generic
• Dutoprol Tablet (metoprolol succinate/hctz)generic
• Dyazide (triamterene/HCTZ capsule)generic
• Dynacin (minocycline HCL capsule)generic
• Dyrenium capsule (triamterene)generic
• Effexor (venlafaxine tablet)generic
• Elavil (amitriptyline tablet)generic
• Elocon Cream (mometasone furoate)generic
• Elocon Ointment (mometasone furoate)generic
• Enulose (lactulose oral solution)generic
• Epinephrine Auto Injector .3mg (epinephrine auto injector)generic
• Eplerenone tablet (eplerenone tablet)generic
• Estrace (estradiol tablet)generic
• Evista (raloxifene tablet)generic
• Evoxac (cevimeline HCl)generic
• Exelon (rivastigmine tartrate capsule)generic
• Exforge (amlodipine and valsartan)generic
• Exforge HCT (amlodipine, valsartan, hydrochlorothiazide)generic
• Femara (letrozole)generic
• Ferrous Sulfate EC tablet (ferrous sulfate EC tablet)generic
• Flecainide Acetate tablet (flecainide acetate tablet)generic
• Flomax (tamsulosin hydrochloride)generic
• Flonase (50 mcg) (fluticasone nasal spray (50 mcg))generic
• Fluvoxamine Maleate tablet (fluvoxamine maleate tablet)generic
• Focalin (Dexmethylphenidate HCl tablet)generic
• Folic Acid (folic acid tablet)generic
• Folic Acid 2.2 tablet (folic acid 2.2 tablet)generic
• Fortical Nasal Spray (Calcitonin-salmon (rDNA origin))generic
• Fosamax (alendronate tablet)generic
• Glucophage (metformin)generic
• Glucophage XR (metformin hcl, extended release)generic
• Glucotrol (glipizide)generic
• Glucotrol XL (glipizide extended release)generic
• Glucovance (glyburide/Metformin tablet)generic
• Glynase PresTab (micronized glyburide)generic
• Haloperidol tablet (haloperidol tablet)generic
• Hexalen capsules (altretamine)generic
• Hydralazine tablet (hydralazine tablet)generic
• Hydrea (hydroxyurea capsule)generic
• hydrochlorothiazide tablet (hydrochlorothiazide tablet)generic
• Hydrocortisone tablet (hydrocortisone tablet)generic
• Hydroxyzine HCL tablet (hydroxyzine HCL tablet)generic
• Hytrin (terazosin capsule)generic
• Hyzaar (antihypertensive combinations)generic
• Imdur (isosorbide mononitrate)generic
• Imitrex (Tablets) (sumatriptan succinate)generic
• Imuran (azathioprine)generic
• Indapamide tablet (indapamide tablet)generic
• Inderal (propranolol tablet)generic
• Inderal LA Capsules (propranolol HCL ER)generic
• Intuniv Extended Release Tablets (guanfacine)generic
• Ismo (isosorbide mononitrate (10mg,20mg))generic
• Isoniazid/INH (isoniazid tablet)generic
• Isoptin-SR (verapamil SR tablet)generic
• Jantoven (warfarin sodium)generic
• K-Dur 20MEQ (potassium chloride ER tablet)generic
• Keppra (levetiracetam tablet)generic
• Keppra XR tablets (levetiracetam ER)generic
• Klonopin (clonazepam tablet)generic
• Klor-Con 10mEQ (potassium chloride ER tablet)generic
• Klor-Con M20 (potassium chloride ER tablet)generic
• Lamictal (lamotrigine)generic
• Lanoxin (digoxin tablets)generic
• Lasix (furosemide tablet)generic
• Levoxyl (levothyroxine)generic
• Lexapro (escitalopram oxalate)generic
• Lexapro 20mg (escitalopram oxalate)generic
• Lexapro 5mg (escitalopram oxalate)generic
• Lidocaine 2% viscous solution (lidocaine 2% viscous solution)generic
• Lidoderm (lidocaine patch 5%)generic
• Lioresal (baclofen tablet)generic
• Lipitor (atorvastatin calcium)generic
• Lithium Carbonate (Lithium Carbonate capsule)generic
• Lodine (etodolac capsule)generic
• Lodine tablet (etodolac tablet)generic
• Lofibra (fenofibrate, micronized capsule)generic
• Lomotil (diphenoxylate hydrochloride/atropine sulfate)generic
• Lonox (diphenoxylate/atropine tablet)generic
• Loperamide capsule (loperamide capsule)generic
• Lopid (gemfibrozil)generic
• Lopressor (metoprolol tartrate tablet)generic
• Lotensin (benazepril tablet)generic
• Lotensin HCT (benazepril HCTZ tablet)generic
• Lotrel (Amlodipine/Benazepril capsule)generic
• Lotrisone Cream (clotrimazole/betamethasone cream)generic
• Lovaza (omega-3-acid ethyl esters)generic
• Loxapine capsule (loxapine capsule)generic
• Lunesta (eszopiclone)generic
• Magnesium Oxide tablet (OTC) (magnesium oxide tablet (OTC))generic
• Mavik (trandolapril tablet)generic
• Maxzide (triamterene/HCTZ tablet)generic
• Mestinon (pyridostigmine bromide)generic
• Metadate CD (methylphenidate CD capsule)generic
• Methotrexate (methotrexate)generic
• Mevacor (lovastatin tablet)generic
• Micardis (telmisartan)generic
• Micronase (glyburide tablet)generic
• Microzide (hydrochlorothiazide capsule)generic
• Midodrine HCl tablet (midodrine HCl tablet)generic
• Minocin (minocycline capsule)generic
• Mirapex tablets (pramipexole dihydrochloride tablets)generic
• Mobic (meloxicam)generic
• Monoket (isosorbide mononitrate (10mg,20mg))generic
• Motrin (ibuprofen tablet)generic
• Mysoline (primidone)generic
• Nabumetone tablet (nabumetone tablet)generic
• Namenda (memantine hcl)generic
• Naprosyn (naproxen tablet)generic
• Neurontin (gabapentin)generic
• Nexium (esomeprazole DR capsule)generic
• Niacin (niacin)generic
• Niacin SA capsule (OTC) (niacin SA capsule (OTC))generic
• Niaspan ER (niacin extented-release tablets)generic
• Nifedipine capsule (nifedipine capsule)generic
• Nilandron tablet (nilutamide)generic
• Nitroglycerin SA capsule (nitroglycerin SA capsule)generic
• Norvasc (amlodipine besylate)generic
• Nystatin powder (nyamyc topical powder)generic
• Nystatin tablet (nystatin tablet)generic
• Ogen (estropipate tablet)generic
• Ortho Micronor (norethindrone tablet)generic
• Ortho-Cyclen (sprintec tablet)generic
• Ortho-Tri-Cyclen (tri-previfem tablet)generic
• Ortho-Tri-Cyclen (tri-sprintec tablet)generic
• Ovcon 35 (norethindrone/ethinyl estradiol tablet)generic
• Oxandrin (oxandrolone tablet)generic
• Pamelor (nortriptyline HCL capsule)generic
• Panretin gel (alitretinoin)generic
• Parnate 10mg tablets (tranylcypromine)generic
• Paxil (paroxetine HCL tablet)generic
• Pepcid (famotidine tablet)generic
• Perphenazine tablet (perphenazine tablet)generic
• PhosLo gelcaps (calcium acetate)generic
• Plaquenil (hydroxychloroquine tablet)generic
• Plavix (clopidogrel bisulfate tablets)generic
• Plendil ER (felodipine ER tablet)generic
• Pletal (cilostazol tablet)generic
• PNV Prenatal Multivitamin Plus Iron (PNV Prenatal Multivitamin Plus Iron)generic
• Potassium Iodide (SSKI oral solution)generic
• Prandin (repaglinide tablet)generic
• Pravachol (pravastatin tablet)generic
• prazosin capsule (prazosin capsule)generic
• Prednisone tablet (prednisone tablet)generic
• Prevacid (lansoprazole DR capsule)generic
• Prevalite Powder (cholestyramine)generic
• Prilosec (omeprazole capsule)generic
• Prinivil (lisinopril tablet)generic
• Prinzide (lisinopril/HCTZ tablet)generic
• ProAir RespiClick Powder Inhaler (albuterol sulfate)generic
• Prochlorperazine tablet (prochlorperazine tablet)generic
• Progesterone capsule (progesterone capsule)generic
• Prograf (tacrolimus capsule)generic
• Propylthiouracil tablet (propylthiouracil tablet)generic
• Proscar (finasteride tablet)generic
• Protonix (pantoprazole sodium)generic
• Provera (medroxyprogesterone acetate)generic
• Prozac (fluoxetine capsule)generic
• Pulmicort Respules (budesonide inhalation suspension)generic
• Qudexy XR capsule (topiramate ER)generic
• Ranexa (ranolazine extended-release tablets)generic
• Reglan (metoclopramide HCL tablet)generic
• Remeron (mirtazapine tablet)generic
• Requip tablets (ropinirole hydrochloride)generic
• Restoril (temazepam)generic
• Restoril (temazepam capsule)generic
• Revatio (sildenafil citrate tablet)generic
• Risperdal (risperidone)generic
• Ritalin (methylphenidate tablet)generic
• Ritalin LA (methylphenidate hcl)generic
• Robaxin (methocarbamol tablet)generic
• Rocaltrol (calcitriol capsule)generic
• Rythmol (propafenone hydrochloride)generic
• Salagen Tablet (pilocarpine)generic
• Septra DS (sulfamethoxazole/trimethoprim DS tablet)generic
• Seroquel (quetiapine fumarate)generic
• Sinemet (carbidopa/levo tablet)generic
• Sinemet CR (carbidopa/levo SR tablet)generic
• Singulair (montelukast sodium)generic
• Sonata (zaleplon)generic
• SSKI oral solution (potassium Iodide)generic
• Synthroid (levothyroxine)generic
• Tamoxifen citrate tablet (tamoxifen citrate tablet)generic
• Tapazole (methimazole tablets)generic
• Tegretol (carbamazepine tablet)generic
• Tenoretic (atenolol/chlorthalidone tablet)generic
• Tenormin (atenolol tablet)generic
• Tessalon Capsule (benzonatate)generic
• Topamax tablets (topiramate)generic
• Trandate (labetalol HCL tablet)generic
• Trental (pentoxifylline ER tablet)generic
• Triamcinolone cream, 0.1% (triamcinolone cream, 0.1%)generic
• Triamcinolone ointment, 0.1% (triamcinolone ointment, 0.1%)generic
• Tricor (fenofibrate)generic
• Trifluoperazine HCl tablet (trifluoperazine HCl tablet)generic
• Trilipix (fenofibric acid DR capsule)generic
• Trospium Chloride tablet (trospium chloride tablet)generic
• Trusopt (dorzolamide HCL)generic
• Ultracet (tramadol hydrochloride/acetaminophen tablets)generic
• Ultram (tramadol tablet)generic
• Ultravate (halobetasol prop ointment, 0.05%)generic
• Urecholine (bethanechol tablet)generic
• Uroxatral (alfuzosin hcl)generic
• Valium (diazepam tablet)generic
• Valtrex tablet (valacyclovir HCL tablet)generic
• Vaseretic (enalapril maleate-hydrochlorothiazide tablets)generic
• Vasotec (enalapril maleate tablet)generic
• Viagra (sildenefil citrate)generic
• Vimpat (lacosamide)generic
• Vistaril (hydroxyzine pamoate)generic
• Vitamin B Complex capsule (OTC) (Vitamin B Complex capsule (OTC))generic
• Vitamin B-6 tablet (OTC) (Vitamin B-6 tablet (OTC))generic
• Vitamin D3 capsule (OTC) (Vitamin D3 capsule (OTC))generic
• Vitamin D3 tablet (OTC) (Vitamin D3 tablet (OTC))generic
• Vogelxo gel packet (testosterone gel packet)generic
• Vogelxo gel pump (testosterone gel pump)generic
• Vogelxo gel tube (testosterone gel tube)generic
• Voltaren (diclofenac EC tablet)generic
• Voltaren XR (diclofenac ER tablet)generic
• Wellbutrin (bupropion HCL tablet)generic
• Wellbutrin SR (bupropion hcl)generic
• Wellbutrin XL (bupropion hcl)generic
• Xalatan (latanoprost solution)generic
• Xanax (alprazolam)generic
• Xopenex (levalbuterol hcl)generic
• Xyzal tablets (levocetirizine dihydrochloride)generic
• Zanaflex (Tizanidine 4mg tab)generic
• Zaroxolyn (metolazone tablet)generic
• Zestoretic (lisinopril/HCTZ tablet)generic
• Zestril (lisinopril tablet)generic
• Ziac (bisoprolol/HCTZ tablet)generic
• Zidovudine tablet (zidovudine tablet)generic
• Zocor (simvastatin tablets)generic
• Zofran (ondansetron tablet)generic
• Zofran ODT (ondansetron ODT tablet)generic
• Zoloft (sertraline HCI)generic
• Zovirax (acyclovir capsule)generic
• Zovirax (acyclovir tablet)generic
• Zyloprim (allopurinol tablet)generic
• Zyprexa (olanzapine)generic
• Zyrtec OTC (cetirizine HCl tablet - OTC)generic