National Kidney Foundation of Arizona

• To qualify, household income must be at or below 400% of Federal Poverty Level with liquid assets not exceeding $2,000 (See FPL Chart)

• The application must document that at least ONE of the following pertains to the patient:

• Albumin < 3.7 g/dL or,

• nPCR (normalized protein catabolic rate) < 0.9gm/kg/day

• 90% standard body weight and/or

Eligibility (in addition to the General Eligibility Requirements on the main page):

• Assistance is available for the 20% copay for immunosuppressants that is not covered by Medicare Part B.

• Assistance is available with the cost of high medication copayments.

• Patient must be approved to be a transplant candidate

• Household income at or below 400% of Federal Poverty Level with liquid assets not exceeding $2,000

• Must have insurance coverage

The program is mandatory generic when a generic exists. For “Dispense as written” prescriptions that specify a brand name drug when a generic is available, NKF AZ will cover the cost of the generic. The patient will be responsible for the difference in cost between the brand name and the generic.

There is no copay per prescription for generic medications. Patients are charged a $5.00 copay per prescription for brand name medications, payable to the pharmacy at the time the prescription is filled. Prescriptions are filled for one month at a time.

The program is mandatory generic when a generic exists. For “Dispense as written” prescriptions that specify a brand name drug when a generic is available, NKF AZ will cover the cost of the generic. The patient will be responsible for the difference in cost between the brand name and the generic.

There is no copay per prescription for generic medications. Patients are charged a $5.00 copay per prescription for brand name medications, payable to the pharmacy at the time the prescription is filled. Prescriptions are filled for one month at a time.