People With Medicare

AZ & Me Prescription Savings Program for People with Medicare Part D

How does the program work?

This program provides drugs made by AstraZeneca, at no cost, to people with Medicare Part D who can't afford their drugs. You can get these drugs by mail order only.

You must qualify for this program. You may be eligible for it if you:

• Are enrolled in a Medicare Part D plan, AND
• Do not qualify for Medicare Part D's extra help, which is available to people with limited incomes and resources, AND
• Meet income limits:
  • Are single and have an income of less than $35,000 per year. These income limits are higher if you live in Alaska or Hawaii.
  • Are married and have a joint income of less than $48,000 per year. These income limits are higher if you live in Alaska or Hawaii.
• Are taking an AstraZeneca drug that this program covers AND
• Have spent at least 3% of your annual household income out-of-pocket this year on prescription drugs. (Important note: Starting January 1, 2013, this last criteria is being eliminated. You will no longer need to have spent 3% of your annual household income on prescription drugs. Read more.)

What drugs does it cover?

The program covers most AstraZeneca drugs. To see the drugs it covers, visit the AZ program website.

How do I get it?

You can:

• Enroll online OR
• Call 1-800-AZandMe (1-800-292-6363) OR
• Download an application. You then must fax the completed form, an AstraZeneca prescription and a copy of last year's federal income tax return for you and your spouse and dependents to 1-800-961-8323.

If I get in, what do I pay?

If you qualify for the program, you pay nothing. There is no cost to enroll or for your drugs.

For more information

Visit the AZ program website, or call 1-800-AZandMe (1-800-292-6363).

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