Free Prescription Program
P.O. Box 221857 Charlotte, NC 28222-1857
Charlotte, NC, Florida 34997

Phone:
Extension:
Toll Free Phone: 1-800-652-6227
Fax: 1-888-526-5168
TDD Phone:

Website: www.jjpaf.org

Program Description

Our programs help uninsured, low-income families and individuals get free prescription medicines.

Services Available Through This Program

Medical Assistance Resources

Hours of Operation

Eligibility Requirements and Important Information

Our free prescription program is available to anyone who meets the requirements listed below. You don't have any insurance or your medicine is not covered. Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. You live in the United States or United States Territory, and you are being treated by a licensed U.S. doctor as an outpatient. You meet the income eligibility for the products below: CONCERTA® (methylphenidate HCI) Extended-Release Tablets CII DARZALEX (daratumumab) Injection for intravenous infusion DOXIL® (doxorubicin HCL liposome) IV Infusion DURAGESIC® (fentanyl) Transdermal System CII EDURANT® (rilpivirine) Tablets ELMIRON® (pentosan polysulfate sodium) Capsules HALDOL® (haloperidol) Immediate-Release Injection HALDOL® Decanoate (haloperidol) IM Injection Only IMBRUVICA® (ibrutinib) Capsules INTELENCE® (etravirine) Tablets INVEGA® (paliperidone) Extended-Release Tablets INVEGA SUSTENNA® (paliperidone palmitate) Extended-Release Injectable Suspension INVEGA TRINZA (paliperidone palmitate) Extended-Release Injectable Suspension INVOKAMET® (canagliflozin/metformin HCI) Tablets INVOKANA® (canagliflozin) Tablets MONOVISC® (high molecular weight hyaluronan) Injection OLYSIO® (simeprevir) Capsules ORTHOVISC® (high molecular weight hyaluronan) Injection PANCREAZE® (pancrelipase) Delayed-Release Capsules PREZCOBIX® (darunavir 800mg/cobicistat 150mg) Tablets PREZISTA® (darunavir) Tablets/Oral Suspension PROCRIT® (epoetin alfa) Injection REMICADE® (infliximab) IV Infusion RISPERDAL® (risperidone) M-TAB® Orally Disintegrating Tablets RISPERDAL® (risperidone) Tablets RISPERDAL® CONSTA® (risperidone) Long-Acting Injection SIMPONI® (golimumab) Injection SIMPONI ARIA® (golimumab) IV Infusion SPORANOX® (itraconazole) Capsules SPORANOX® (itraconazole) Oral Solution STELARA® (ustekinumab) Injection SYLVANT® (siltuximab) IV Infusion TOPAMAX® (topiramate capsules) Sprinkle Capsules TOPAMAX® (topiramate) Tablets XARELTO® (rivaroxaban) Tablets YONDELIS® (trabectedin) Injection for intravenous infusion ZYTIGA® (abiraterone acetate) Tablets

Availability and Fees

Current Wait List:	NO
Handicapped Access:	NO
Accepts Medicaid:	NO
Accepts Medicare:	NO
Accepts Private Insurance:	NO
Financial Assistance Available?:	YES
Sliding Scale:	NO

Other Fee Information

Other Useful Information