Premphase

Indicated For

menopause, hot flashes, vaginal dryness, osteoporosis prevention

About This Medication

# Pfizer Patient Assistance Program Patient Guide: How to Get Premphase at Low or No Cost ## About This Program The Pfizer Patient Assistance Program provides eligible patients with free Premphase (conjugated estrogens/medroxyprogesterone acetate) through Pfizer Inc. and the Pfizer Patient Assistance Foundation. This program is designed to help uninsured and underinsured patients access their prescribed medications without financial hardship. ## About Premphase Premphase is a hormone replacement therapy medication containing conjugated estrogens and medroxyprogesterone acetate. It is prescribed to manage moderate to severe vasomotor symptoms (hot flashes and night sweats) associated with menopause. The medication works by supplementing the body's natural hormone levels during menopause. ## Who Qualifies for Free Premphase To be eligible for the Pfizer Patient Assistance Program, you must meet ALL of the following requirements: - **Have a valid prescription** written by a U.S. licensed healthcare provider for Premphase - **Be uninsured or underinsured** (have government insurance like Medicare or Medicaid but cannot afford your out-of-pocket costs) - **NOT be covered by commercial insurance** (patients with private health insurance are not eligible for free medicine through this program) - **Meet income requirements** based on your household size - **Be a U.S. resident** (including Puerto Rico and U.S. territories) - **Have an FDA-approved indication** for Premphase ### Income Eligibility Your household income must be at or below the specified Federal Poverty Level (FPL) threshold. The income limits vary based on your household size: | Household Size | Maximum Annual Income (at 400% FPL) | |---|---| | 1 person | Approximately $18,400 | | 2 people | Approximately $24,800 | | 3 people | Approximately $31,200 | | 4 people | Approximately $37,600 | | 5 people | Approximately $44,000 | | 6 people | Approximately $50,400 | *Note: These figures are approximate and based on 2026 Federal Poverty Level guidelines. Exact thresholds may vary. Contact the program directly for your specific household size.* ### Special Considerations for Medicare Patients If you have Medicare Part D or Medicare Advantage coverage: - You must first enroll in the voluntary Medicare Prescription Payment Plan (MPPP) - You must know your monthly co-payment and annual out-of-pocket maximum ($2,100 for most Medicare Part D/Advantage patients) - You must demonstrate inability to afford your co-payment - You must not have reached your annual out-of-pocket maximum - You may be required to apply to other available funding resources first and provide documentation of denial ## Insurance Requirements **Commercially insured patients are NOT eligible** for free medicine through this program, regardless of income or formulary status. However, if you have government insurance (Medicare, Medicaid) and cannot afford your out-of-pocket costs, you may qualify. ## How to Apply for Free Premphase ### Step 1: Gather Required Documents Before applying, collect the following: - Your prescription for Premphase from your healthcare provider - Proof of household income (choose one): - Prior year tax return - Most recent W-2 forms - 3 most recent paycheck stubs for all household members - Electronic income verification - Proof of U.S. residency - Information about your current insurance coverage (or proof of no insurance) ### Step 2: Complete the Enrollment Form You can apply through multiple methods: - **By phone:** Call (800) 438-1985 to request an application or apply over the phone - **Online:** Visit www.PfizerRxPathways.com to download and submit an application - **Through your healthcare provider:** Your doctor's office may help you complete and submit the form ### Step 3: Submit Your Application Submit your completed enrollment form along with all required documentation. You can mail it, submit it online, or have your healthcare provider submit it on your behalf. ### Step 4: Await Approval Decision The program will review your application and notify you of the decision within 2-3 weeks of submission. ## Timeline and Medication Delivery **Processing Time:** You will receive notification of your eligibility status within 2-3 weeks of submitting your complete application. **Delivery Method:** Once approved, Premphase will be: - Shipped directly to your home, OR - Sent to your healthcare provider's office for pickup Your approval letter will include specific instructions on how you will receive your medication and your enrollment term. ## Reauthorization Your enrollment in the program is not permanent. You will need to reauthorize your participation periodically. The program will notify you when reauthorization is required and provide instructions for renewal. ## What If Your Application Is Denied? If you are denied assistance, you have several options: 1. **Review the denial reason** - Contact the program at (800) 438-1985 to understand why you were not approved 2. **Verify your information** - Ensure all income and residency documentation was accurate 3. **Explore alternatives** - Ask your healthcare provider about: - Generic alternatives to Premphase - Other patient assistance programs - Pharmaceutical company discount programs - State pharmaceutical assistance programs - Community health center resources 4. **Reapply** - If your circumstances change (income decreases, insurance status changes), you may reapply ## Important Reminders - **Enrollment is subject to change** - Program eligibility requirements and income thresholds may be updated at any time - **Valid prescription required** - You must have a current prescription from a licensed U.S. healthcare provider - **Income verification is mandatory** - You must provide proof of household income - **U.S. residency required** - The program serves U.S. residents, including those in Puerto Rico and U.S. territories - **Alternate funding requirement** - You may be required to apply to other available funding sources first ## Contact Information **Pfizer Patient Assistance Program** - Phone: (800) 438-1985 - Website: www.PfizerRxPathways.com ## Disclaimer This guide provides general information about the Pfizer Patient Assistance Program for Premphase. Program eligibility requirements, income thresholds, and procedures are subject to change at any time without notice. For the most current and accurate information, contact the program directly or visit the official website. This information is not a guarantee of eligibility or approval. Always consult with your healthcare provider regarding your treatment options and medication needs.

Program information last verified: March 30, 2026