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 Yourself | All States and Washington D.C., Except Alaska and Hawaii | Alaska | Hawaii |
|---|---|---|---|
You  | Not more than $51,040 per year | Not more than $63,800 per year | Not more than $58,720 per year |
| You + 1 | Not more than $68,960 per year | Not more than $86,200 per year | Not more than $79,320per year |
| You + 2 | Not more than $86,880 per year | Not more than $108,600per year | Not more than $99,920per year |
| You + 3 | Not more than $104,800 per year | Not more than $131,000 per year | Not more than $120,520 per year |
