Bristol-Myers Squibb Patient Assistance Program

Requirements for uninsured applicants

• Patient must be at or below 300% federal poverty level to qualify
  • View federal poverty guidelines
• Medications can be shipped to the patient’s home
• Applications are good for 1 year from the date approved by the program

Requirement for Medicare Part D applicants

• Medicare Part D enrollees are required to have spent 3% of their total household income on medications year to date before they are able to apply
• Applications for Medicare Part D enrollees are valid until December 31st of the current enrollment year