Brilinta

Indicated For

Acute Coronary Syndrome (ACS), coronary artery disease

About This Medication

# AZ&Me Patient Guide: How to Get Brilinta (ticagrelor) at Low or No Cost Brilinta (ticagrelor) is a prescription medication used to prevent heart attacks, strokes, and other serious cardiovascular events in adults. The **AZ&Me Prescription Savings Program** by AstraZeneca offers **free Brilinta** to eligible US patients who meet specific income and insurance criteria, helping those facing high costs get life-saving treatment without financial strain[1]. ## About Brilinta and Why Assistance Matters **Brilinta (ticagrelor)** is a blood thinner, or antiplatelet medication, that works by preventing platelets in your blood from clumping together. This reduces the risk of clots forming, which can lead to heart attacks or strokes. It's commonly prescribed after a heart attack, for people with acute coronary syndrome (ACS), or those with a history of heart disease. Unlike some other blood thinners like aspirin or clopidogrel (Plavix), Brilinta provides stronger, faster protection but can be expensive—often over $400 per month without insurance or discounts[1]. High drug costs affect millions of Americans. If you're struggling to afford Brilinta, the AZ&Me program can provide it **at no cost** for up to 12 months, with options to re-enroll. This guide walks you through everything you need to know, from eligibility to applying, in simple steps[1]. ## Who Qualifies for AZ&Me? AZ&Me is designed for **US residents** (citizenship not required) who: - Have a valid prescription for Brilinta from a US-licensed healthcare provider. - Live at or below **400% of the Federal Poverty Level (FPL)** based on household income and size. - Lack adequate insurance coverage for Brilinta or have high out-of-pocket costs. - Are not enrolled in government programs like Medicaid (except Medicare Part D) **Key exclusions**: Patients on Medicaid, Medicare (with limitations), VA, Tricare, or similar government programs may not qualify. Private insurance is allowed if it doesn't cover Brilinta adequately[1]. ## Income Eligibility Breakdown Eligibility hinges on your **household income** compared to the Federal Poverty Level (FPL). AZ&Me typically covers those at or below **400% FPL**. Use the table below for 2026 guidelines (FPL updates annually; confirm current levels via AZ&Me). | Household Size | 100% FPL | 400% FPL (Eligibility Threshold) | |----------------|----------|---------------------------------| | 1 (Individual) | $15,060 | $60,240 | | 2 (Couple) | $20,440 | $81,760 | | 3 | $25,820 | $103,280 | | 4 | $31,200 | $124,800 | | +1 per member | +$5,380 | +$21,520 | *Notes*: Include all household income sources (wages, Social Security, etc.). Assets are not typically counted. Call 1-800-292-6363 to verify your exact eligibility[1]. ## Insurance Requirements - **No government insurance** (e.g., Medicaid, VA) except **Medicare Part D** (may qualify if copays are unaffordable). - **Private/commercial insurance** OK if it doesn't cover Brilinta or requires high copays/deductibles. - Programs with 'specialty drug carve-outs' (requiring third-party assistance first) are eligible[1]. If uninsured or underinsured, you're a prime candidate. Your doctor must confirm coverage details on the Provider Form. ## Step-by-Step Application Process 1. **Get your prescription**: Ask your doctor for Brilinta and discuss AZ&Me. 2. **Download forms**: Visit the AZ&Me website or call 1-800-292-6363 (Mon-Fri, 9 AM-6 PM ET) for the Patient Application (AZMEAPPv2p1) and Provider Form[1]. 3. **Fill out Patient Application**: Use blue/black ink. Include: - Personal info (name, DOB, address, gender). - Product: Brilinta (ticagrelor). - Application type: New or Re-enroll. - Sign Page 2 authorization for info sharing[1]. 4. **Doctor completes Provider Form**: They verify diagnosis, prescription, and insurance. 5. **Gather documents**: Proof of income (tax returns, pay stubs, SSI letters), ID, insurance card (if applicable). 6. **Submit**: Fax both forms to 1-877-239-0867. Keep copies! 7. **Follow up**: Call AZ&Me for status. ## Timeline and Delivery - **Processing**: 2-4 weeks after receiving complete forms[1]. - **Delivery**: Free medication shipped directly to your doctor's office or pharmacy for pickup. No home delivery mentioned. - **Supply**: Up to 3-month supply per shipment; re-enroll for refills. ## Alternatives if Denied or Ineligible - **Manufacturer Savings Card**: AstraZeneca's Brilinta Savings Card for commercial insurance (up to $250 off/month). - **Other PAPs**: Partnership for Prescription Assistance (PPARx.org) or NeedyMeds.org. - **Generic ticagrelor** (if available; check FDA). - **Patient Access Network (PAN) Foundation** for copay help. - **State programs** or 340B clinics. - Appeal denial by calling AZ&Me or reapplying with updated info[1]. ## Important Disclaimer This guide is for informational purposes only and based on available AZ&Me details as of 2026. Program rules can change; always verify with AstraZeneca at 1-800-292-6363 or their website. Not medical advice—consult your doctor. AstraZeneca may update FPL thresholds or requirements. Free medication is not guaranteed; eligibility determined by program[1]. (Word count: 950)

Program information last verified: March 30, 2026