Application

1Step
See if you qualify. You qualify for Rx Outreach as long as your annual household income is:
  • $35,010 or less for a single person
  • $47,190 or less for a family of two
  • Add $12,180 for each additional person
  • $59,370 or less for a family of three
  • $71,550 or less for a family of four

2Step

See if your medicine is on the Rx Outreach Medication List:
Most drugs can be purchased for $20 for a 180-day supply. The list shows the administrative fees for all drugs offered. Administrative fees shown are for any dose, any strength. So even if you take more than one pill a day, our administrative fee is still the same!


3Step

Get a prescription from your doctor.
Prescriptions may be written with refills available for up to one year. Ask your doctor about a 180-day supply with one refill or a 90-day supply with three refills. Prescriptions may be faxed to 1-800-875-6591. FAXED PRESCRIPTIONS ARE ONLY ACCEPTED FROM A HEALTHCARE PROVIDER’S OFFICE/FACILITY. Please arrange for payment prior to having your prescription faxed. Once payment and prescription are received, please allow 24-48 hours for processing.


4Step
Online application:
Immediate Enrollment- Create a simple web account then enroll/re-enroll online.

or, mail a completed application, your prescription(s) and your payment to:
Rx Outreach
P.O. Box 66536
St. Louis, MO 63166-6536

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