No guarantees of assistance are made by PSA, and PSA does not distribute or sell medications and is no way responsible for the timing or delivery of such medications. PSA does not determine who qualifies for Patient Assistance Programs (PAP’s). Various PAP sponsors make all decisions about which drugs are to be included in the programs and which individuals receive assistance, and that not all medications are covered. The program’s sponsors can modify or discontinue the programs without notice. PAP’s are available to all qualified individuals FREE of charge, and the client is solely responsible for paying PSA for their services in the processing and filing of applications for PAP programs and NOT for the medications. Fees are payable regardless of whether the medication is received (please see our refund policy below). PSA will use all reasonable commercial efforts to enroll the client in the various PAP’s offered by the pharmaceutical companies for the medications prescribed by the client’s physician.
The client must agree to provide PSA with all requested documentation necessary to apply for the various PAP programs, including, but not limited to proof of income, prescriptions, Doctor’s signatures and customer’s signature on all applications, copy of Medicare card and/or insurance information, tax documents, etc. The client mus certify that any and all information they provide is accurate and true to the best of their knowledge. The pharmaceutical companies determine where and when medications are shipped. Some pharmaceutical companies may charge an additional “re-stocking fee” to be paid if a prescription is picked up medication at a local pharmacy. The client assumes all responsibility for notifying PSA of any changes regarding personal information or medications. Certain PAP programs, may require the client or their personal physician to file certain forms.
A client may cancel an agreement with PSA and receive a full refund by returning UNUSED, ALL paperwork received from PSA along with a written request within 30 days. After 30 days, PSA will guarantee a full refund, upon written request, to any applicant who receives no medication and is determined to be ineligible for assistance by ALL manufacturers. Refund requests due to ineligibility must be made within 120 days of the date of this application, accompanied by a copy of each manufacturers’ letter denying assistance. No refund will be given unless PSA is provided a copy of each manufacturer’s denial letter. Either party may cancel this agreement by giving ten (10) days written notice.
A client is required to appoint
PSA their attorney-in-fact for the limited purposes of signing
on their behalf any communications or agreements with pharmaceutical
companies, or other entities engaged by them to administer. Patient
Assistance Programs, to which a client may apply, and disclosing
to such entities any of the medical information contained in the
application form or proof of income documents submitted by the