Tirosint-SOL

Indicated For

hypothyroidism

About This Medication

# IBSA Patient Assistance Program Patient Guide: How to Get Tirosint-SOL at Low or No Cost Tirosint-SOL (levothyroxine sodium oral solution) is a brand-name thyroid hormone replacement medication from IBSA Pharma, designed for people with hypothyroidism or other thyroid conditions. The **IBSA Patient Assistance Program** provides this medication **free of charge** to eligible patients who lack prescription insurance and meet income guidelines, helping ensure access to vital treatment without financial burden.[1][2] ## About Tirosint-SOL **Tirosint-SOL** is a liquid form of levothyroxine sodium, a synthetic thyroid hormone (T4) that your body converts to T3 to regulate metabolism, energy, heart rate, and more. Unlike traditional tablets, its **gel-cap solution** avoids fillers like dyes, gluten, or lactose, making it ideal for patients with allergies, sensitivities, or absorption issues. It's taken once daily on an empty stomach, precisely dosed for consistent thyroid levels. Always follow your doctor's dosing instructions, as improper use can affect heart function or bone health.[1][2][7] ## Who Qualifies? This program targets uninsured U.S. residents facing financial hardship. Key requirements: - **No prescription insurance** (including Medicare Part D, Medicaid, or other government plans). - **U.S. residency** with proof. - **Household income at or below 200% of the Federal Poverty Level (FPL)** for 48 states (higher thresholds may apply in Alaska/Hawaii; confirm via program).[1][2][3] Patients on government health plans are **not eligible**. If you have any prescription coverage, explore other options first.[2] ## Income Eligibility Breakdown Eligibility hinges on **annual household income** compared to 2024 FPL guidelines (used as reference; call for updates). Here's a clear table for common household sizes:[2] | Household Size | 200% FPL Threshold (48 States) | |----------------|-------------------------------| | 1 (Individual) | $29,160 | | 2 (Couple) | $39,440 | | 3 | $49,720 | | 4 | $60,000 | | 5 | $70,280 | | 6 | $80,560 | | 7 | $90,840 | | 8 | $101,120 | | 8+ | Add $10,280 per extra person | **Notes**: Income includes all household earners. Provide recent proof like tax returns, pay stubs (two consecutive periods), or benefit statements. Non-Medicare, uninsured only.[1][2] ## Insurance Requirements **Strict no-prescription-insurance rule**: You must have **zero** coverage for prescription drugs. **Medicare, Medicaid, Tricare, VA, or similar government plans disqualify you**. If recently insured, ensure coverage has fully lapsed. The program verifies this—misrepresentation leads to denial. Privately uninsured patients qualify if income fits.[1][2][3] ## Step-by-Step Application Process Applying is straightforward but requires completeness to avoid delays. Download the form from tirosintsol.com or call for one.[1][2] 1. **Gather Documents**: - Completed application (both pages; serves as prescription). - **Proof of income** (e.g., 2024 tax return, W-2, two pay stubs, SSI/SSDI statement). - **Proof of residency** (utility bill, lease; include name/DOB on all). - **Prescriber details** (name, address, NPI, signature/date; stamps invalid).[1][2] 2. **Fill Out Form**: Patient signs for HIPAA/income verification; doctor signs as prescriber.[1] 3. **Submit**: - **Mail**: IBSA Patient Assistance Program, P.O. Box 1229, Southampton, PA 18966. - **Fax** (prescriber office only): 1-833-340-7196 with cover sheet (prescriber contact/NPI/patient name). No patient faxes accepted.[1][2] - Phone support: (833) 838-3247 for questions.[1] **Tip**: Make copies of everything—documents aren't returned. Ensure all sections complete.[1] ## Timeline and Delivery - **Processing**: 2-4 weeks after receipt. You'll get eligibility notification by mail.[1][2] - **If Approved**: First shipment is a **3-month (90-day) supply** mailed free to your home.[1][2] - **Refills**: Call (833) 838-3247 for more through calendar year end. Monthly refills possible up to 1 year.[2][7] - **Re-enrollment**: Required annually; re-qualify each calendar year.[2] ## Alternatives if Denied or Ineligible - **Income too high?** Check **Tirosint-SOL savings card** on tirosintsol.com for copay help (commercial insurance only).[2] - **Medicare?** Use Extra Help (SSDI) or Low-Income Subsidy; state pharmaceutical aid.[3] - **Other PAPs**: RxAssist.org lists generics or competitors (no biosimilars for Tirosint-SOL).[3][6] - **Generic levothyroxine**: Cheaper oral tablets; discuss with doctor for switches. - **Contact program** for denial reasons/appeals.[1][5] ## Reauthorization Process Once approved, refills are phone-based until year-end. **Reapply fully** next year with updated income/residency proof. Doctor must re-sign.[2] ## Important Disclaimer This guide summarizes publicly available info as of latest sources; **program details can change**. Verify with IBSA at (833) 838-3247 or tirosintsol.com. Not medical/financial advice—consult your doctor/pharmacist. IBSA denies liability for application errors. Free meds don't replace insurance; explore all options. Word count: 1028.

Program information last verified: March 30, 2026