Exforge

Indicated For

hypertension

About This Medication

# Novartis Patient Assistance Foundation Patient Guide: How to Get Exforge at Low or No Cost ## About This Program The Novartis Patient Assistance Foundation (NPAF) helps patients afford Exforge (amlodipine valsartan), a medication used to treat high blood pressure. If you struggle to pay for your prescription, this program may provide your medication at no cost or reduced cost. The program is designed for uninsured patients, those with limited prescription coverage, and patients with government insurance who meet specific income requirements. ## Who Qualifies for NPAF To be eligible for the Novartis Patient Assistance Foundation program, you must meet all of the following requirements: - **Reside in the United States or a U.S. Territory** - **Have limited or no prescription insurance coverage** (or have insurance that doesn't cover Exforge) - **Meet income guidelines** based on your household size - **Have a valid prescription** for Exforge from a licensed U.S. healthcare provider - **Be treated on an outpatient basis** (not in a hospital or institution) If you have Medicare Part D coverage, you may still qualify, but you'll need to show that you were denied Extra Help (also called Low-Income Subsidy) or that Extra Help doesn't cover your medication. ## Income Eligibility NPAF uses income guidelines that vary by household size and state. Your household income is determined based on your most recent federal tax return (Form 1040). The program considers your total household size when determining eligibility. | Household Size | Income Requirement | |---|---| | 1 person | Varies by state | | 2 people | Varies by state | | 3 people | Varies by state | | 4+ people | Varies by state | **To find your specific income limit:** Contact NPAF at (800) 277-2254 or visit the Novartis Patient Assistance website to verify income requirements for your household size and state. ## Insurance Requirements You must have **limited or no prescription drug coverage** to qualify. This means: - You are uninsured - Your insurance doesn't cover Exforge - Your insurance coverage is very limited - You have a high deductible or copay that makes the medication unaffordable **Medicare Part D patients:** If you have Medicare Part D, you may still qualify if you were denied Extra Help or if Extra Help doesn't cover Exforge. You'll need to provide documentation of your Extra Help denial. **Prior Authorization denials:** If your insurance company denied coverage through Prior Authorization, include that denial letter with your application. ## Step-by-Step Application Process ### Step 1: Check Your Eligibility Before applying, verify that you meet the basic requirements. Call NPAF at (800) 277-2254 (Monday-Friday, 9 AM-6 PM EST) to confirm income limits for your household size and state. ### Step 2: Gather Required Documents Collect the following documents before starting your application: - **Proof of income:** First 2 pages of your most recent federal tax return (Form 1040). If you're not required to file taxes, contact NPAF directly. - **Insurance information:** Copies of the front and back of all insurance cards (primary, secondary, and prescription insurance) - **Valid prescription:** Your doctor must provide a current prescription for Exforge - **Extra Help denial (if applicable):** If you have Medicare Part D, include documentation showing you were denied Extra Help - **Prior Authorization denial (if applicable):** If your insurance denied coverage, include that letter ### Step 3: Complete the Application You and your healthcare provider must each complete your sections of the application form. The application includes: - **Patient section:** Your personal information, household size, income details, insurance information, and authorization for NPAF to contact your doctor - **Healthcare provider section:** Your doctor's information, the prescription for Exforge, and authorization to release medical information Make sure every field is completed accurately. Incomplete applications will be delayed or denied. ### Step 4: Submit Your Application Submit your completed application and all required documents by: - **Fax:** (855) 817-2711 - **Mail:** Novartis Patient Assistance Foundation, Inc., P.O. Box 2529, Columbus, OH 43216 Include copies (not originals) of all documentation. ### Step 5: Wait for a Decision NPAF will review your application and send you a decision letter within approximately **4 weeks**. You may also receive a text message update if you opted in during the application process. ## Timeline and Medication Delivery - **Application review:** Approximately 4 weeks from submission - **Decision notification:** You'll receive a letter with the outcome - **Medication delivery:** If approved, your medication will be shipped directly to you or your healthcare provider ## What Happens If Your Application Is Denied If NPAF denies your application, the decision letter will explain why. Common reasons include: - Income exceeds program limits - Missing or incomplete documentation - Insurance coverage that doesn't qualify - Not meeting other eligibility criteria **Next steps if denied:** - Review the denial letter carefully - Contact NPAF at (800) 277-2254 to discuss your situation - Ask if you can reapply with additional information - Explore other assistance options, such as state pharmaceutical assistance programs or nonprofit organizations ## Reauthorization and Refills Your assistance through NPAF is not permanent. You will need to **reauthorize your assistance periodically** to continue receiving Exforge through the program. NPAF will notify you when reauthorization is required. Be prepared to provide updated income documentation and insurance information. ## Important Restrictions NPAF does not provide medication to patients who have insurance associated with alternative funding programs that condition, restrict, or adjust coverage based on applying to NPAF or other free goods programs. ## Contact Information - **Phone:** (800) 277-2254 (Monday-Friday, 9 AM-6 PM EST) - **Fax:** (855) 817-2711 - **Mail:** Novartis Patient Assistance Foundation, Inc., P.O. Box 2529, Columbus, OH 43216 - **Website:** Visit pap.novartis.com for additional information ## Disclaimer This guide provides general information about the Novartis Patient Assistance Foundation program. Program eligibility, requirements, and benefits may change. For the most current and accurate information, contact NPAF directly or visit the official website. This guide is not a guarantee of eligibility or approval. Always consult with your healthcare provider about your medication and treatment options.

Program information last verified: March 30, 2026