Boehringer

LINK: http://us.boehringer-ingelheim.com/our_responsibility/patients-

families/patient_assistance_program.html

You must be a legal US resident.

You cannot have prescription drug coverage or assistance through Medicaid, Medicare, Medicare Part

D or private insurance.

If you have Medicare Part D but are unable to meet your prescription drug costs you still may be

eligible for patient assistance. Special circumstances are evaluated on a case by case basis.

Income guidelines for the program were not specified but income documentation is required. In can

be assumed your annual gross income must be at or below the federal poverty line.

Medications available through the Patient Assistance Program:

Aggrenox®

Jardiance®

Pradaxa®

Aptivus®

Jentadueto®

Spiriva Handihaler ® &

Spiriva Respimat®

Atrovent HFA®

Mirapex®

Striverdi®

Respimat®

Combivent®

Respimat®

Mirapex ER®

Tradjenta®

Gilotrif®

Ofev®

Viramune XR®

Glyxambi ®

Phone: (706) 208 9700   Mail: info@pcpmail.org