Program Details
RXOUTREACH
Rx OUTREACH - Diabetic Supplies
Prodigy Preferred Blood Glucose Monitor
(blood glucose monitor)
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CONTACT
INFO |
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Address: |
PO Box 66536
St. Louis, MO 63166-6536 |
Phone: |
1-800-769-3880 |
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.
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Income at or below: |
Single |
$32,490 |
300
% FPL |
|
Couple |
$43,710 |
300
% FPL |
|
Credit
for Dependents allowed |
Other Income
Requirements: |
$54,930 for family of 3
$66,150 for family of 4
Add $11,220 for each additional person |
Medical expenses
can be deducted from reported income: |
Not
Published |
Social security requested on form: |
Yes |
US citizenship/residency specified:
|
Not
Published |
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APPLICATION |
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Attachments
Required: |
Financial
Also include check, money order or credit card information.
|
Physician
License #
Required: |
Not Required
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Prescriber
Signature
Allowed: |
Only patient needs to sign the application. |
Application
may be
faxed: |
No
|
Eligibility
determination
letter sent: |
None
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MEDICATION |
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Receives: |
Medication
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Shipped To: |
Provider
Products sent to wherever the patient requests it.
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Quantity in
Shipment: |
Prodigy Preferred Blood Glucose Monitor - 1 free per year
Strips - $15 for a box of 50 = minimum order 2 boxes for $30
Lancets 28G - $5 for a box of 100 = minimum order of 2 boxes for $10 |
Delivery Time: |
0-1 week
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Re-application
Policy: |
New application every 12 months
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Refill Policy: |
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Other Information: |
A separate application must be submitted for each household member applying for medication. |
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Last Updated: 05/08/2023
www.RxAssist.org
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