Patient Assistance Program
Quest Healthcare, A Division of Quest Products LLC, is committed to providing access to ENEMEEZ® for those most in need. If you are experiencing financial hardship and have limited or no prescription coverage, then you may be eligible to receive ENEMEEZ® at discounted pricing, regardless of your insurance coverage.
Eligibility
To be eligible:
- Be a U.S. resident or legal resident
- Have no prescription drug coverage through commercial insurance or a government program, or have been denied coverage by government programs or commercial insurance
- Not receiving other prescription assistance
- Must meet household income equal to or less than:
- $35,000 for an individual
- $48,000 for a family of two
- $60,000 for a family of three
- $70,000 for a family of four
- $80,000 for a family of five
Call 1-800-650-0113, ext. 3, with acceptable proof of income
Verification of income documents includes: *QUEST PRODUCTS WILL NOT HOLD ANY PERSONAL OR CONFIDENTIAL INFORMATION
- Federal Income Tax Form (1040, 1040A, 1040EZ, 1040X, 1099INT, 1722)
- W2 Tax Statement
- Social Security, or Pension Statements
- Statements of interest, dividends, or other income
- Letter of denial from government program or insurance company
Enrollment Terms & Limitations
I understand that Quest Healthcare, A Division of Quest Products LLC, will review the information I have provided to determine my eligibility and notify me accordingly.
This program is valid only to legal U.S. residents. This program may be terminated or modified at any time. If any such revision or revocation occurs, the applicant will be notified either by phone or mail.
Each approved participant in this program will be limited to one 30-count box per month.
Contact the Enemeez Patient Assistance Program: 1-800-650-0113