Thank you for choosing Name Brand Rx, patient advocacy program. It is our mission to help you obtain prescription medication for FREE or at low cost to you. We provide these services for individuals who do not have government or private resources available to them. With the soaring cost of medication, some people have to choose between buying their medication or basic necessities (i.e. food, bills, childcare). We at Name Brand Rx strive to eliminate this disparity. We do not believe good health should be an 'OPTION'; it should be your right. Our program offers assistance with nearly 5,000 Name Brand maintenance medications. Name Brand Rx's Advocate team is committed and is made up of professionals with the experience and the know how to service, and help the uninsured and under-insured low income individuals in America who cannot afford their Name Brand medicines.
No matter how many prescriptions you have, you only pay ONE low monthly fee. Name Brand Rx was founded on one principle – your health is your greatest asset! So live it up and enjoy all that life has to offer!
Low cost and even Free Prescription Medications are available now with a Name Brand Rx membership. Over the last 10 years we have gained the trust and working relationships with the pharmaceutical manufactures of over 4,300 Name Brand medications!
We collect information from you when you register on our site, place an order or fill out a form. When ordering or registering on our site, as appropriate, you may be asked to enter your: name, e-mail address, mailing address, phone number, credit card information or social security number. You may, however, visit our site anonymously.
What do we use your information for?
Any of the information we collect from you may be used in one of the following ways: To Improve Customer Service(your information helps us to more effectively respond to your customer service requests and support needs)
To Process Transactions Your information, whether public or private, will not be sold, exchanged, transferred, or given to any other company for any reason whatsoever, without your consent, other than for the express purpose of delivering the purchased product or service requested. To Administer a Contest, Promotion, Survey or Other Site Feature To Send Periodic Emails The email address you provide for order processing, may be used to send you information and updates pertaining to your order, in addition to receiving occasional company news, updates, related product or service information, etc.
How do we protect your information?
We implement a variety of security measures to maintain the safety of your personal information when you place an order We offer the use of a secure server. All supplied sensitive/credit information is transmitted via Secure Socket Layer (SSL) technology and then encrypted into our Payment gateway providers database only to be accessible by those authorized with special access rights to such systems, and are required to keep the information confidential. After a transaction, your private information (credit cards, social security numbers, financials, etc.) will be kept on file for more than 60 days in order to maintain customer service.
Do we disclose any information to outside parties?
We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.
Membership and Fee Agreement
I. It is our intent to offer the very best service in our endeavor to assist our members with free or low cost medications as requested by their physician. The information provided by "Name Brand Rx" is not to replace the relationship that exists between the member and his or her physician or make medication suggestions. We are not a physicians nor are we pharmacists and do not act in such manner. All advice of this nature must be obtained from your physician.
II. Our services include assisting the member by furnishing the necessary forms and documents requested by the various pharmaceutical companies as outlined in their individual assistance programs. This will include claim forms, (the prescription section must be completed by your physician), proof of income as specified by the drug manufacturer (also known as the pharmaceutical company) and any other information deemed necessary by the pharmaceutical company to determine eligibility for assistance. All information supplied to "Name Brand Rx" is held in strictest confidence and will not be supplied to anyone without prior written consent.
III. Acceptance into any "assistance" program is determined by the pharmaceutical company and/or the drug manufacturer not "Name Brand Rx". At the pharmaceutical company's discretion any "assistance" program can be discontinued at any time without prior notice.
IV. Name Brand Rx is not responsible for any delay in shipment of medication(s) or the misplacement of medication(s) at your physician's office. It is your (the member's) responsibility to ensure your physician is prepared and willing to accept the shipment of medications on your behalf. Each medication has its own "assistance" program and application process from which it is supplied and all medications will not be delivered or arrive at the same time.
As a member you agree to the following;
Pay the enrollment fee of $59.00 and the monthly membership fee as follows: $40.00 per month. Your membership will cover processing of any application into assistance program for name brand medications/products that (1) are prescribed by your doctor (2) available for assistance and (3) you meet the required minimum qualifications for.
You will be billed and responsible for the minimum amount $40.00; depending on the number of medications we are assisting you with, every month for the total amount of both Name Brand Rx and the assistance program fees.
In the event of a delay in the shipment of your medication(s) or delivery or your medication(s), you will still be held responsible for the payment of the appropriate monthly fee for our services.
Delinquency: After three (3) months of delinquent or non-payment, Name Brand Rx has the right to remove the
member associated with the delinquent account, resulting in the discontinuance of our service which may result
in the discontinuance of the shipment of your medications. After the removal, any and all documents will be properly
destroyed. Should you decide to re-enroll into this program, you will be required to pay any past due balance before
re-enrollment is considered plus the enrollment fee of $59. Re-enrollment will require the signing of a new contract
and an update of all necessary documents (proof of income, etc.)
Cancellation: If you acquire prescription coverage while your membership is still active, we will need proof of
coverage before you are considered inactive in our program. The only forms of proof that will be accepted will be
either an active prescription coverage card or an official letter from the insurance company stating that your
prescription costs will covered by their program. In that event, this contract will be null and void. Should you decide
you no longer need our services; a written letter of cancellation is required and must be sent to our office via email or
mail. You can obtain this information from our office. In the event of cancellation, you will still be held responsible for
any current balance on the account.
All transactions are final -- no refunds will be given.
Terms within this contract are subject to change without prior notice.
Name Brand Rx has the RIGHT to refuse service to anyone.
This contract will continue through the length of your membership with Name Brand Rx or until your membership is terminated by Name Brand Rx.
-All applications are to be taken to your doctor’s office as soon as possible.
-The doctor is to fill in and sign all highlighted areas and attached a separate prescription for each medication. If you
leave the applications at your doctor’s office; it is your responsibility to get those applications back to our office. (The
longer it takes to get the applications back – the longer it takes to receive your medications.)
-Provide Name Brand Rx with any and all necessary financial documentations.
-Notify Name Brand Rx of any correspondence received from any pharmaceutical company.
-Notify Name Brand Rx of any household changes.
-Notify Name Brand Rx of any change in medication therapy.
California Online Privacy Protection Act Compliance
Because we value your privacy we have taken the necessary precautions to be in compliance with the California Online Privacy Protection Act. We therefore will not distribute your personal information to outside parties without your consent.
We are in compliance with the requirements of COPPA (Children's Online Privacy Protection Act), we do not collect any information from anyone under 13 years of age. Our website, products and services are all directed to people who are at least 13 years old or older.
Terms and Conditions
Please also visit our Terms and Conditions section establishing the use, disclaimers, and limitations of liability governing the use of our website at www.namebrandrx.com
This policy was last modified on 09/23/2013