The Merck Patient Assistance Program Helps Those in Need

You may be eligible for the program if all 3 of the following conditions apply:

1. You reside in the United States and are age 19 or older⁽¹⁾

   AND

2. You do not have insurance or other coverage for your prescription medicine. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, veterans assistance, or any other social service agency support.⁽²⁾

   AND

3. You have an annual household income less than⁽³⁾:

   • $60,240 or less for individuals
   • $81,760 or less for couples
   • $124,800 or less for a family of 4.

⁽¹⁾ You do not have to be a US citizen. Residents of the United States, including US Territories, are also eligible.

⁽²⁾ If you do not meet the insurance coverage criteria, your income meets the program criteria, and there are special circumstances of financial and medical hardship that apply to your situation, you can request that an exception be made for you. Patients may not have an insurance plan or employer that participates in or are involved in any way with an alternative funding program that requires or encourages you to apply to the Merck Patient Assistance Program as a condition, requirement, or prerequisite for coverage of specific Merck medications.

⁽³⁾ For income limits in Alaska and Hawaii, please call 1-800-727-5400.