The Merck Patient Assistance Program Helps Those in Need

You may qualify for patient assistance⁽¹⁾ if you meet all 3 of the following conditions:

1. You are a US resident and have a prescription for a Merck product from a health care provider licensed in the United States.⁽²⁾

   AND

2. You do not have insurance or other coverage for your prescription medicine. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, veterans assistance, or any other social service agency support.⁽³⁾

   AND

3. You cannot afford to pay for your medicine.You may qualify for the patient assistance program if you have a household income of $79,800 or less for individuals, $108,200 or less for couples, or $165,000 or less for a family of 4.⁽⁴⁾

⁽¹⁾ Offered through the Merck Patient Assistance Program, Inc.

⁽²⁾ You do not have to be a US citizen. Legal residents of the United States, including US Territories, are also eligible.

⁽³⁾ If you do not meet the insurance coverage criteria, your income meets the program criteria, and there are special circumstances of financial and medical hardship that apply to your situation, you can request that an exception be made for you. Patients may not have an insurance plan or employer that participates in or are involved in any way with an alternative funding program that requires or encourages you to apply to the Merck Patient Assistance Program as a condition, requirement, or prerequisite for coverage of specific Merck medications.

⁽⁴⁾ For income limits in Alaska and Hawaii, please call 1-800-727-5400.