When filling out our enrollment form, you will need:
- Your personal contact details
- Information for any medications that cost you more than $60 per month
- Your prescribing healthcare provider’s information so we can get required paperwork filled out by them.
- Payment information on file.
Once you submit your enrollment form, we will be able to determine within 48 hours whether you qualify. If you qualify, we will process your first payment and request income verification.
We will also request needed information from your healthcare provider.
Your first order of medication is typically received 2 to 4 weeks after all paperwork is received from you and your healthcare provider.
