Exelon Patch

Indicated For

Alzheimer's disease dementia, Parkinson's disease dementia

About This Medication

# Novartis Patient Assistance Foundation Patient Guide: How to Get Exelon Patch (rivastigmine) at Low or No Cost The **Novartis Patient Assistance Foundation (NPAF)** offers **Exelon Patch (rivastigmine)** free to eligible patients facing financial hardship with no prescription insurance coverage. This guide explains eligibility, application steps, and support options in simple terms.[1][2] ## About Exelon Patch (rivastigmine) **Exelon Patch** is a prescription skin patch containing **rivastigmine**, used to treat symptoms of mild-to-moderate dementia due to Alzheimer's disease or Parkinson's disease. It works by increasing levels of certain chemicals in the brain to help improve memory, thinking, and daily functioning. The patch is applied once daily and comes in different strengths (4.6 mg/24h, 9.5 mg/24h, 13.3 mg/24h) as prescribed by your doctor. Common side effects include nausea, vomiting, diarrhea, loss of appetite, dizziness, headache, and skin irritation at the patch site. Always follow your healthcare provider's (HCP) instructions and report side effects.[1][2] ## Who Qualifies for the Program? NPAF helps U.S. residents (including territories) treated outpatient by a licensed U.S. HCP who: - Have **limited or no prescription insurance** (no public or private third-party coverage).[1][3][6] - Meet **income guidelines** based on Federal Poverty Level (FPL), varying by household size, product, state (higher in Alaska/Hawaii), and financial hardship.[1][6] - Have a **valid prescription** for Exelon Patch.[3] Patients with any prescription coverage, including Medicare Part D, typically do not qualify unless they provide proof of denial (e.g., Extra Help denial). Health plans or pharmacies cannot enroll you—only patients, guardians, or caregivers can.[2][3] ## Income Eligibility Breakdown Exact income thresholds are **not fixed** and vary by household size, specific medication (like Exelon Patch), state, and year. They are typically set at **300-400% of the Federal Poverty Level (FPL)** or less, adjusted for hardship. Check current limits at www.PAP.Novartis.com or call (800) 277-2254.[1][2][6] Use this table as a general reference (based on 2025 FPL guidelines; confirm with NPAF for 2026 updates): | Household Size | Example Max Income (Contiguous U.S., ~400% FPL) | Alaska (~482% FPL) | Hawaii (~542% FPL) | |---------------|------------------------------------------------|---------------------|---------------------| | 1 | ~$60,000 | ~$72,000 | ~$81,000 | | 2 | ~$81,000 | ~$98,000 | ~$110,000 | | 3 | ~$102,000 | ~$123,000 | ~$138,000 | | 4 | ~$123,000 | ~$148,000 | ~$166,000 | | +1 person | +$21,000 | +$25,000 | +$28,000 | *Notes: Household size matches your tax return (Form 1040). Provide proof like first 2 pages of 1040, W-2, 1099, pay stubs, or Social Security statements. Non-filers contact NPAF. Thresholds may be lower/higher per product—always verify.[1][3][6][8] ## Insurance Requirements You must have **no third-party prescription coverage** (private insurance, Medicare, Medicaid, etc.). Submit front/back copies of **all** insurance cards (primary, secondary, Rx). If insured but denied coverage (e.g., prior authorization rejection or Extra Help denial), include those documents. Medicare patients often need Extra Help denial proof. NPAF verifies everything.[1][2][3] ## Step-by-Step Application Process 1. **Check Eligibility**: Visit www.PAP.Novartis.com or call (800) 277-2254 (Mon-Fri, 9am-6pm ET) to confirm for Exelon Patch.[2][3] 2. **Download Form**: Get the application from www.PAP.Novartis.com or Novartis site.[1][2] 3. **Complete Patient Section**: Fill personal info, household size, income, insurance details. Sign patient authorization (allows info sharing with NPAF/caregiver).[1][3] 4. **Gather Documents**: - First 2 pages of recent tax return (1040) or income proof (W-2, pay stubs, 1099).[1][6][8] - All insurance cards (front/back).[1] - Prior auth denial or Extra Help letter if applicable.[1][2] 5. **HCP Completes Their Section**: Doctor fills diagnosis, prescription, signs authorization. Include original Rx (unless retail card product).[3][4][8] 6. **Submit**: Fax to 1-855-817-2711 or mail to NPAF, PO Box 2529, Columbus, OH 43216 (or current address like PO Box 52029, Phoenix, AZ 85072).[1][4][6] **Tip**: Double-check completeness—missing info causes delays/denials. Opt in for texts on status.[2] ## Timeline and Delivery - **Processing**: Up to **4 weeks** for decision letter (mailed; text if opted in).[2][6] - **If Approved**: Medication **shipped free to your home** (not doctor's office). Supply duration varies; reapply as needed.[1][2] - **Status Updates**: Call (800) 277-2254 if no letter after 4 weeks.[2] ## Alternatives if Denied or Ineligible - **Reapply** with missing docs or updated info.[2] - **Appeal**: Contact NPAF for reasons and next steps.[7] - **Other Programs**: Check PANO (oncology), co-pay cards (if insured), or state programs. Use RxHope.com, Simplefill (877-386-0206), or NeedyMeds.org.[5][9] - **Generic rivastigmine**: Ask HCP about cheaper options (no biosimilars listed).[1] - **Medicare Extra Help**: Apply at SSA.gov if low-income. ## Important Disclaimer This guide is for informational purposes based on available NPAF details as of 2026. Eligibility, guidelines, addresses, and processes can change—**always verify at www.PAP.Novartis.com or (800) 277-2254**. NPAF reserves rights to modify/deny/verify at discretion. Not medical/financial advice; consult your HCP/ advisor. Novartis not liable for errors. Word count: 1028.

Program information last verified: March 30, 2026