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Medicine Pills
Medications

Bristol-Myers Squibb Patient Assistance Foundation, Inc.


This program provides certain Bristol-Myers Squibb medications at no cost to you. This is a temporary assistance program that looks at your financial and medical needs. You will not need to pay any co-pays or enrollment fees to get help from this program. Once enrolled, you will receive a supply of the medication in the amount needed for your treatment or as determined by the program. In addition, the program will work with you and/or your physician to determine where your medication will be shipped.

How do I apply?


To apply for this program, print and fill out the application form. Please return the completed application to the program as instructed on the form.

Frequently Asked Questions

Am I eligible?

You can get help from this program if you have limited income and are a citizen or resident of the United States. You cannot have health insurance that can cover the cost of your treatment.

Can I get help from this program if I have Medicare?

If you have Medicare Prescription Drug coverage and have spent at least 3% of your gross annual household income on out-of-pocket prescription costs for the medications available through the Bristol-Myers Squibb Patient Assistance Foundation, you can take part in this program. However, you cannot enroll in the program if you receive Medicare's Low Income Subsidy/Extra Help for your prescription costs.

What will I need?
Who should I contact?

Bristol-Myers Squibb Patient Assistance Foundation, Inc.
P.O. Box 220769
Charlotte, NC 28222
Toll-Free: (800) 736-0003
Fax: (800) 736-1611
Website: http://www.bmspaf.org