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 $49,960 per yearNot more than $62,400 per yearNot more than $57,520 per year
You + 1 Not more than $67,640 per yearNot more than $84,520 per yearNot more than $77,840 per year
You + 2 Not more than $85,320 per yearNot more than $106,640 per yearNot more than $98,160 per year
You + 3 Not more than $103,000 per yearNot more than $128,760 per yearNot more than $118,480 per year