1-877-236-2170 6509 BERGENLINE AVENUE WEST NEW YORK, NJ 07093, UNITED STATES

Empire Specialty Pharmacy Financial Assistance Program

 

There is no doubt medical treatments can put a strain on your budget, even when you have medical insurance. It is not uncommon for there to be a significant gap between what your insurance company will pay for a treatment and what is left for you, the patient, to pay out of pocket.  The professionals at Empire Specialty Pharmacy can work with you to find extra money to help pay your medical expenses. This can include foundation grants and co-pay assistance to cover the gap often left by your insurance coverage. We are here to help find ways you can pay for high co-pays and deductibles so that there is no gaps in your treatments.

  • Empire Specialty Pharmacy staff will determine if you meet the income criteria for assistance by asking a few simple questions.
  • We’ll help you in understanding the required supporting documents you may need to send in with your application.
  • We will work with your physician to complete any forms needed to accompany the application.
  • Our staff will follow up with status reports on the application.
  • You will notified of your approval for financial assistance.
  • Our staff will explain how much assistance the program will provide and how much medication it covers. Once you have used that amount of medication, we’ll let you know how much you will be responsible to pay for and when that responsibility will start.
The application process for financial assistance is straight-forward and easy, with Empire Specialty Pharmacy on your side.

 

To get started simply fill out this form and mail, fax, bring it in to Empire Specialty Pharmacy

Empire Financial Assistance Form

Getting started is easy. Download the form below and fax, mail, bring it in to the pharmacy. We will help you through the entire process.

Empire Financial Assistance Form