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PATIENT ASSISTANCE PROGRAM






CONTACT ABBOTT NUTRITION'S PATIENT ASSISTANCE PROGRAM FOR QUESTIONS




1-866-801-5657

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PATIENT ASSISTANCE PROGRAM

Abbott Nutrition believes that access to products recommended by healthcare providers is important for all patients. If you do not have access to alternative sources of coverage or funding of Abbott Nutrition products, you may qualify for Abbott Nutrition’s Patient Assistance Program. This program is designed to provide supplemental product at no cost to eligible patients experiencing financial difficulties.








How do I know if I’m eligible for the Patient Assistance Program?

To qualify, patients must:


  • Reside in one of the 50 states or the District of Columbia and have no healthcare insurance coverage for the requested product;
  • Have no access to alternative sources of coverage or funding;

  • Meet financial eligibility criteria; and
  • Require 100% of their caloric needs from the requested product.







All applications are reviewed on a case-by-case basis to support the Program’s purpose of providing products at no cost to individuals in need. Abbott Nutrition products available through the Program are those listed within this application and should be used under medical supervision.






How do I apply for Abbott Nutrition’s Patient Assistance Program?








1-process

Download and complete the Patient Information section of the Patient Assistance Program application. Work with your healthcare provider to complete the other sections of the application.



2-process

Ensure all sections of the application are completed. Make a copy for your records before sending as no documents will be returned.



3-process

Attach current proof of income (tax return, W2, pay stub) for all individuals in patient household.

4-process

Sign and date the application.



5-process

Have your prescriber sign and date the application.



6-process

You or your healthcare provider should fax the completed application to 1-866-734-7353 or mail to the following address:

Abbott Nutrition Patient Assistance Program

P.O. Box 4280

Gaithersburg, MD 20885-4280









Upon receipt of a completed application, the patient will be notified of program eligibility. The approved supply of product will be shipped to the patient’s home unless otherwise specified.