Rx Outreach

Rx Outreach is a low-cost prescription medication program for people in need across the U.S. Prescriptions are mailed directly to the patient after receipt of an Rx Outreach form, a prescription, and payment.

Contact Information:

Rx Outreach

Phone: (800) 769-3880

Fax:

How to Apply:

Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to the PPA.

Eligibility:

Rx Outreach is a patient assistance program that offers patients access to more than 400 prescription medications. Patients must qualify based on income.

Other information:

Medications in this program are available in 90-day and/or 180-day supplies. Over 150 medications are available in a 6-month supply for just $20.

Product(s) covered by program:

AcipHex®
Acyclovir
Albuterol
Alclometasone Dipropionate Cream
Alendronate
Allopurinol
Alprazolam
Amiodarone
Amitriptyline
Amlodipine
Amlodipine Besylate
Aricept
Atenolol
Atenolol/Chlorthalidone
Atorvastatin
Baclofen
Belladonna Alkaloids/Phenobarbital Tablet
Benazepril
Benazepril/HCTZ
Benztropine Mesylate
Betamethasone Aug. Dipropionate Cream
Betamethasone Dipropionate Cream
Betamethasone Valerate
Bicalutamide
Bisoprolol/HCTZ
Bumetanide
Bupropion
Bupropion HCL SR
Bupropion HCL XL
Buspar Dividose
Butalbital APAP Caffeine Tablet
CARBATROL®
Captopril
Carvedilol
Chlordiazepoxide
Chlorpromazine HCL
Chlorthalidone
Cilostazol
Citalopram
Clindamycin
Clonazepam
Clonidine
Clopidogrel
Colchicine Tablet
Cyclobenzaprine
Dacogen®
Diazepam
Diclofenac ER
Dicyclomine
Digoxin Tablet
Diltiazem ER
Diphenoxylate/Atropine
Divalproex DR
Doxazosin
Doxepin
Enalapril Maleate
Escitalopram tablet
Estradiol
Estropipate
Etodolac
Famotidine
Felodipine ER
Fibricor™
Finasteride
Fluconazole
Fluocinonide Cream
Fluoxetine
Fluticasone Nasal Spray
Folic Acid
Furosemide
Gabapentin
Gemfibrozil
Geodon®
Glimepiride
Glipizide
Glipizide ER
Glynase®PresTab®
Halcion®
Hexalen® capsule
Hydralazine
Hydrochlorothiazide/HCTZ
Hydrocortisone
Hydroxychloroquine
Hydroxyurea
Hydroxyzine HCL
Hydroxyzine Pamoate
Hyoscyamine ER
Hyoscyamine-SL Tablets
Ibuprofen
Indapamide
Irbesartan
Isoniazid
Isosorbide Mononitrate
Isosorbide Mononitrate ER
Labetalol
Lamotrigine
Leflunomide
Letrozole
Levetiracetam
Levetiracetam ER
Levoxyl®
Lisinopril
Lisinopril/HCTZ
Lithium Carbonate
Lorazepam
Losartan
Losartan/HCTZ
Lovastatin
Meclizine
Medroxyprogesterone Tablet
Meloxicam
Metformin
Metformin ER
Methotrexate
Metoclopramide
Metolazone
Metoprolol Tartrate
Minocycline
Mirtazapine
Mometasone Furoate Cream
Montelukast Sodium
Mycophenolate Mofetil
Nabumetone
Nadolol
Naproxen Sodium
Nifedipine ER
Nitroglycerin SA
Nitrostat®
Norethindrone
Norethindrone Acetate
Norethindrone/Ethinyl Estradiol
Nortriptyline
Nystatin
Nystatin Cream/Ointment
Nystatin/Triamcinolone Cream/Ointment
Olanzapine
Omeprazole
Ondansetron
Ondansetron ODT
Oxcarbazepine
Oxybutynin
POTASSIUM CHLORIDE EXTENDED RELEASE TABLETS
Panretin® gel 0.1%
Pantoprazole
Paroxetine
Pentoxil®
Phenytoin Sodium
Pioglitazone HCL
Piroxicam
Potassium Chloride
Pramipexole
Pravastatin
Prazosin
Prednisone
ProAir® HFA Inhaler
Prochlorperazine
Propafenone
Propranolol
Propylthiouracil
Quetiapine Fumarate
Quinapril
Ramipril
Ranitidine
Risperidone
Ropinirole
Sertraline
Simvastatin
Spironolactone
Sprintec®
Stavudine
Sulfamethoxazole/Trimethoprim
Sulfamethoxazole/Trimethoprim DS Tablet
Sulfasalazine
Sumatriptan Succinate
Tamoxifen Citrate
Targretin®
Temazepam
Terazosin
Theophyline ER
Ticlopidine
Timolol Maleate ophthalmic Solution
Tizanidine
Topiramate
Torsemide
Tramadol
Trandolapril
Trazodone
Tri-Sprintec®
Triamterene/HCTZ
Trianex®
Valsartan/HCTZ
Venlafaxine
Venlafaxine ER
Verapamil
Verapamil SR
Warfarin
Warfarin Sodium
Zafirlukast
Zaleplon
Zolpidem
Zolpidem ER
Zonegran®
diclofenac EC