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Lupron Depot Patient Assistance Program

Summary

Abbott Patient Assistance Foundation (Lupron Depot).

Eligibility

Lupron Depot Patient Assistance Program, a patient assistance program provided by Abbott Patient Assistance Foundation (Lupron Depot), Inc.offers Lupron Depot at no cost to those who are eligible for the program. The patient or physicians must contact Abbott Patient Assistance Foundation regarding refills. Eligibility is based off of the following requirements:

- You must not be covered by private or public health insurance.

- Your income must be less than or equal to 300% of the Federal Poverty Guideline for the size of your household (see chart below).

- You must be a citizen of the United States or its Territories.

- You must be diagnosed with

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

SOURCE: 2008 Poverty Chart
Family Size
300%
250%
200%
150%
133%
100%
1
$32,490
$27,075
$21,660
$16,245
$14,404
$10,830
2
$43,710
$36,425
$29,140
$21,855
$19,378
$14,570
3
$54,930
$45,775
$36,620
$27,465
$24,352
$18,310
4
$66,150
$55,125
$44,100
$33,075
$29,327
$22,050
5
$77,370
$64,475
$51,580
$38,685
$34,301
$25,790
6
$88,590
$73,825
$59,060
$44,295
$39,275
$29,530
7
$99,810
$83,175
$66,540
$49,905
$44,249
$33,270
8
$111,030
$92,525
$74,020
$55,515
$49,223
$37,010
Each Additional Family Member
$11,220
$9,350
$7,480
$5,610
$4,974
$3,740

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Abbott Patient Assistance Foundation (Lupron Depot) program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

Other Tips

  • If you have any questions please call the Abbott Patient Assistance Foundation (Lupron Depot) program directly.
  • Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in.
  • Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don't run out of medication.
  • Do not write messy on your forms as this will delay any response.
  • Call and write thank you notes to AAI Pharma Inc. program. Without their help millions of people will be without medication.

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