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Medicines or adult vaccines distributed through the Merck Patient Assistance Programs are free of charge to all eligible patients. Merck is not associated with any individuals or organizations that may charge patients a fee to assist them in completing enrollment forms for our programs.


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These individuals or organizations are acting independently of Merck, and do not have Merck's consent. Toggle navigation. Who May Qualify How to Get Started Check your Eligibility Who May Qualify If you have been prescribed a Merck medicine, you may be eligible for the program if all 3 of the following conditions apply: You are a US resident and have a prescription for a Merck product from a health care provider licensed in the United States.

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AND You cannot afford to pay for your medicine. After downloading the application or receiving your packet in the mail, follow these simple steps to submit your enrollment form for your free Merck medicines: Complete ALL information on the enrollment form. You may fill in the fields online and print it. OR You may print out the form and fill it out by hand using a black ballpoint pen. A single application may include prescriptions for up to 3 Merck medicines. Each prescription may not exceed a day supply at a time, with a maximum of 3 refills. Each application is valid for up to 12 months; after 12 months a new application will be required.

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Under certain circumstances, enrollment may be limited to a calendar year. Section 2 is your prescription. For additional applications or assistance, please call Criminal Law. Employment Law.

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