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)
PHA is proud to be able to make educational materials and programs like these available for free to everyone because of the generous support from members of the community just like you. Donations are welcome!