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Program Overview

Mail or fax application to:
Pfizer Connection to Care Program
PO Box 66585
St. Louis, MO 63166-6585
fax: 1-866-470-1748

Connection to Care® provides eligible patients with their Pfizer medicines for free through their doctor's office.* If you’re a health care professional, click here.
How to qualify
To receive free Pfizer medicines, patients must:
  • Have been prescribed a Pfizer medicine available through Connection to Care
  • Have no prescription coverage or qualify for hardship assistance
  • Meet the household income guidelines for the program
  • Live in the United States, Puerto Rico, or the US Virgin Islands

To view a list of available medicines, click here.

Household income guidelines
The total gross annual household income for a patient must be at or below 2 times the federal poverty guidelines, adjusted for family size. (See chart below.)

  • Total number of persons in the household includes the patient and each of his or her dependents
  • Total gross income includes incomes from all earners in the household before taxes and deductions

Please visit www.aspe.hhs.gov/poverty for more information about federal poverty guidelines. For households of more than 5 people, or for those who live in Alaska or Hawaii, call
1-866-706-2400.

Hardship assistance may be available for patients who have prescription coverage and are faced with serious financial hardship (eg, cannot afford their coinsurance, or have been denied coverage). Patients who are accepted into Connection to Care through hardship assistance will receive their Pfizer medicine for free until the end of the calendar year. If they are still in need of assistance after that time, they can reapply to the program.
Application process
Applying is easy. Just follow these 2 steps:
  1. Download an application here.
  2. Patients and their prescribers must fill out and either mail or fax the completed application, along with proof of income, to Connection to Care. For Lyrica® (pregabalin), patients are also required to include the original prescription and copy of their photo ID.

Proof of income includes a copy of one of the following documents that shows total gross annual household income:

  • Previous year’s federal tax return (form 1040 or 1040EZ)
  • Current paycheck stub
  • Wage and tax statements (W-2 forms)
  • Social security, pension, or railroad retirement statements (SSA-1099 or similar)
  • Statements of interest, dividends, or other income (1099-INT, 1099, 1099-DIV, or similar forms)

Patients should keep a photocopy of their application and original income documents.

Application approval
Patients will receive notification of their enrollment status in the mail within 3 to 4 weeks of submitting their completed application. If accepted, they will be enrolled for up to 1 year. They can reapply to the program each year if they continue to need assistance.
Application help
For step-by-step instructions on how to complete the application, click here.
How patients receive their medicines
Once patients are approved, a 90-day supply of medicine will be shipped to their prescriber’s office for pick-up.

Prescribers are then responsible for placing 90-day medicine reorders throughout their patients’ enrollment. Prescribers can place reorders online via the Connection to Care Provider Portal at www.PfizerPAP.com, or through our automated phone reordering system at 855-742-7497.

There are certain exceptions to this process.

  • For patients taking Lyrica or living in the US Virgin Islands or Puerto Rico, the medicine will be shipped to their home. These patients can place their own refills throughout their enrollment by calling 877-486-5367.
  • For patients taking Quillivant XR™ (methylphenidate hydrochloride) CII for extended-release oral suspension, medicine will be available through participating retail pharmacies. Upon being accepted into the program, patients will be sent a Connection to Care card.* They can bring this card, along with any Quillivant XR™ prescriptions they receive during enrollment, to participating pharmacies to redeem their medicines for free.

It is important to note that Quillivant XR™ is the only Connection to Care medicine that can be accessed at the pharmacy with a Pfizer Connection to Care card.

This guide explains eligibility requirements, how to get started on the program, and how you will receive your medicines.

Download English Guide
Download Spanish Guide

For Health Care Professionals

Program Overview for HCPs

By reading this guide, you can help patients access the medicines they need through Connection to Care.

Download

Medicine Change Request Form

Use this form to add a new medicine, or make a change to an existing medicine, for enrolled Connection to Care patients.

Download

Patient care in real time

Use the Connection to Care Online Provider Portal to view enrollment history, reorder medicines, and track Connection to Care patient shipments.

Launch portal at www.PfizerPAP.com

*Certain exceptions apply. See section entitled “How patients receive their medicines” for additional details.

†Federal poverty guidelines for 2013.

‡The Connection to Care card is not health insurance. For a complete list of participating pharmacies, please click here or call 866-706-2400. There are no membership fees to participate.


Contact Us
For additional support, call 1-866-706-2400.
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