Do you qualify for Rx Outreach?

Answer the simple questions below to determine if you are eligible for Rx Outreach, or use the table below.

Congratulations, You qualify.

Click the Enroll Online button to enroll in the program.

Please call us to see if you qualify.
Based on your income information we were unable to determine your eligibility. Please call us at 1-888-RXO-1234 (1-888-796-1234) to speak with a Patient Care Advocate.

Number of People in your household, Including YourselfAll States and Washington D.C., Except Alaska and HawaiiAlaskaHawaii
You Not more than $51,040 per yearNot more than $63,800 per yearNot more than $58,720 per year
You + 1 Not more than $68,960 per yearNot more than $86,200 per yearNot more than $79,320per year
You + 2 Not more than $86,880 per yearNot more than $108,600per yearNot more than $99,920per year
You + 3 Not more than $104,800 per yearNot more than $131,000 per yearNot more than $120,520 per year