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Free Medication Program


We are always looking for ways to help patients get the medications they need. Our innovative programs have helped tens-of-thousands of people across the country for the past 5 years. We are proud to introduce our new program. Patients can receive up to 30 day supply of select popular brand medications absolutely Free. It is easy for you, your physician's office or an advocate to apply on your behalf to get up to 30 day supply of medications free. Your free medication will be shipped within one to two weeks after your request is approved by your physician.

Please Note: This service is not currently available in Montana. Certain offers may not be valid in Massachusetts.


You can apply online or you may choose to print an online prescription form to take to your physician:

Current Free Medication List

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Print Form  ABILIFY 10MG Print Form  ABILIFY 15MG Print Form  ABILIFY 20MG
Print Form  ABILIFY 2MG Print Form  ABILIFY 30MG Print Form  ABILIFY 5MG
Print Form  ABILIFY DISCMELT 10MG Print Form  ABILIFY DISCMELT 15MG Print Form  ACCU-CHECK AVIVA KIT
Print Form  ACIPHEX 20MG Print Form  ADVAIR DISKUS 100-50MCG Print Form  ADVAIR DISKUS 250-50MCG
Print Form  ADVAIR DISKUS 500-50MCG Print Form  ADVAIR HFA 115-21MCG Print Form  ADVAIR HFA 230-21MCG
Print Form  ADVAIR HFA 45-21MCG Print Form  ANTARA 43MG Print Form  ARICEPT 23MG
Print Form  ASCENSIA BREEZE 2 Print Form  ASCENSIA CONTOUR SYSTEM Print Form  ASMANEX TWISTHALER 30INHL 110MCG
Print Form  ASMANEX TWISTHALER 30INHL 220MCG Print Form  AXERT 12.5MG Print Form  AXERT 6.25MG
Print Form  AXIRON 30MG Print Form  BRILINTA 90MG Print Form  CADUET 10-10MG
Print Form  CADUET 10-20MG Print Form  CADUET 10-40MG Print Form  CADUET 10-80MG
Print Form  CADUET 2.5-10MG Print Form  CADUET 2.5-20MG Print Form  CADUET 2.5-40MG
Print Form  CADUET 5-10MG Print Form  CADUET 5-20MG Print Form  CADUET 5-40MG
Print Form  CADUET 5-80MG Print Form  COLCRYS 0.6MG Print Form  COMBIPATCH 0.14-0.05MG/24HR
Print Form  COMBIPATCH 0.25-0.05MG/24HR Print Form  CRESTOR 10MG Print Form  CRESTOR 20MG
Print Form  CRESTOR 5MG Print Form  DILANTIN 100MG Print Form  ENJUVIA 0.3MG
Print Form  ENJUVIA 0.45MG Print Form  ENJUVIA 0.625MG Print Form  ENJUVIA 0.9MG
Print Form  ENJUVIA 1.25MG Print Form  EXELON 4.6MG/24HR Print Form  EXELON 9.5MG/24HR
Print Form  FANAPT 10MG Print Form  FANAPT 12MG Print Form  FANAPT 1MG
Print Form  FANAPT 2MG Print Form  FANAPT 4MG Print Form  FANAPT 6MG
Print Form  FANAPT 8MG Print Form  FORTESTA 10MG Print Form  FREESTYLE LITE
Print Form  INTUNIV 1MG Print Form  INTUNIV 2MG Print Form  INTUNIV 3MG
Print Form  INTUNIV 4MG Print Form  INVEGA 1.5MG Print Form  INVEGA 3MG
Print Form  INVEGA 6MG Print Form  INVEGA 9MG Print Form  JANUMET 50-1000MG
Print Form  JANUMET 50-500MG Print Form  JANUVIA 100MG Print Form  JANUVIA 25MG
Print Form  JANUVIA 50MG Print Form  LESCOL XL 80MG Print Form  LUNESTA 1MG
Print Form  LUNESTA 2MG Print Form  LUNESTA 3MG Print Form  MAXALT 10MG
Print Form  MAXALT 5MG Print Form  MAXALT MLT 10MG Print Form  MAXALT MLT 5MG
Print Form  MICARDIS 20MG Print Form  MICARDIS 40MG Print Form  MICARDIS 80MG
Print Form  MYFORTIC 180MG Print Form  MYFORTIC 360MG Print Form  NEORAL 100MG
Print Form  NEORAL 100MG/ML Print Form  NEORAL 25MG Print Form  NIASPAN 1000MG
Print Form  NIASPAN 500MG Print Form  NIASPAN 750MG Print Form  ONFI 10MG
Print Form  ONFI 20MG Print Form  ONFI 5MG Print Form  RAPAFLO 4MG
Print Form  RAPAFLO 8MG Print Form  RAPAMUNE 0.5MG Print Form  RAPAMUNE 1MG
Print Form  RAPAMUNE 2MG Print Form  RYBIX ODT 50MG Print Form  SILENOR 3MG
Print Form  SILENOR 6MG Print Form  SIMCOR 1000-20MG Print Form  SIMCOR 1000-40MG
Print Form  SIMCOR 500-20MG Print Form  SIMCOR 500-40MG Print Form  SIMCOR 750-20MG
Print Form  SINGULAIR 10MG Print Form  SINGULAIR 10MG Print Form  SINGULAIR 4MG
Print Form  SINGULAIR 4MG Print Form  SINGULAIR 5MG Print Form  SYMBICORT 160-4.5MCG
Print Form  SYMBICORT 80-4.5MCG Print Form  TOVIAZ 4MG Print Form  TOVIAZ 8MG
Print Form  VESICARE 5MG Print Form  VIVELLE-DOT 0.025MG/24HR Print Form  VIVELLE-DOT 0.0375MG/24HR
Print Form  VIVELLE-DOT 0.05MG/24HR Print Form  VIVELLE-DOT 0.075MG/24HR Print Form  VIVELLE-DOT 0.1MG/24HR
Print Form  VYTORIN 10-10MG Print Form  VYTORIN 10-20MG Print Form  VYTORIN 10-40MG
Print Form  VYTORIN 10-80MG Print Form  ZETIA 10MG Print Form  ZOLOFT 100MG
Print Form  ZOLOFT 25MG Print Form  ZOLOFT 50MG Print Form  ZORTRESS 0.25MG
Print Form  ZORTRESS 0.5MG Print Form  ZORTRESS 0.75MG

* Availability subject to change without prior notice. Please Note: This service is not currently available in Montana.