Hydroxychloroquine is available as the brand-name drug Plaquenil. Generic drugs usually cost less than the brand-name version. Hydroxychloroquine may be used as part of a combination therapy. Chloroquine diphosphate salt autophagy Hydroxychloroquine liquid Plaquenil eye symptoms Hydroxychloroquine with methotrexate combination steroid This is a copay assistance program for patients that have health insurance. The patient's insurance must cover the qualifying medication that they are seeking assistance for. Patient with Medicare Part D will be considered on a case by case basis. Patients must be at or below 400-500% of the federal poverty level. Patients come first. Since 2004, we have provided over $3 billion in assistance to nearly 1 million patients. With a best-in-class compliance program, efficient operations and a low administrative cost, we are your most trustworthy partner. Learn more. Plaquenil Patient Access Network Foundation PAN This is a copay assistance program Provided by Patient Access Network Foundation TEL 866-316-7263 FAX 866-316-7261 Languages Spoken English, Spanish, Others By Translation Service. Program Website Program Applications and Forms Hydroxychloroquine is used to treat lupus erythematosus and rheumatoid arthritis. It isn’t fully understood how this drug works to treat lupus erythematosus or rheumatoid arthritis. That means you may need to take it with other drugs. It treats malaria by killing the parasites that cause the disease. Plaquenil patient assistance forms PLAQUENIL Patient Assistance Program, PAN Foundation - The Help You Need Ocular side effects of hydroxychloroquineItching plaquenilWhat happens if you take hydroxychloroquine without foodPlaquenil and detached retinaChloroquine solubility dmso Depending on the health insurance plan, savings may apply toward co-pay, co-insurance or deductible. Eligible patients pay $5 per injection with a $20,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Patient Resources SIMPONI® golimumab. NeedyMeds. Hydroxychloroquine Plaquenil. Re-application New application every 12 months Additional Information *Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease. The Patient or Advocate should contact the Hotline to apply on behalf of a patient. An application is sent to the caller for completion and signature by both the Patient and Doctor, in addition to a signed prescription. Patient assistance programs PAPs are programs created by drug companies, such as MYLAN, to offer free or low cost drugs to individuals who are unable to pay for their medication. These Programs may also be called indigent drug programs, charitable drug programs or medication assistance programs.