Flolan® Patient Assistance Program
This program covers patients who lack coverage for Flolan®. You must financially qualify for this assistance.
Who is Eligible?
You are eligible if you meet all
of the following criteria:
- Have an income at or below 500% Federal Poverty Level
- Take the medication for a FDA-approved diagnosis
- Reside in the United States
- Proof that you have applied for Social Security Disability, Medicare and Medicaid
How Do I Apply?
- Call for a pre-screening.
An application will then be sent to you.
- Fill out and submit the application.
Both you and your doctor must fill out separate sections and sign the application. The approval decision is usually mad within 24-48 hours.
How Does The Program Work?
If you are approved for patient assistance, you will be eligible to receive Flolan® and Flolan® Diluent for one year at no cost.
Shannon or Heather
3000 Ericsson Drive, Suite 100
Warrendale, PA 15086
Find out more information about Flolan® (epoprostenol)