Drug Discount Program

Citizens Memorial Hospital knows patients are concerned about the high cost of prescription medications. As a participant in the federal 340B Drug Pricing Program, CMH receives discounts on drugs purchased for use by CMH outpatients. We have attempted to pass along a significant portion of these discounts to our patients.

Use the application below to express your interest in receiving drug discounts on prescriptions written by eligible CMH providers. Only patients who have completed this application and meet financial criteria related to income, assets and/or out-of-pocket drug expenditures will be eligible for such discounts.

If you have questions about the application process, please call 417-328-6108.

Renewal applicants: Please have the following documentation in digital form to load as part of the application.

• Last tax return
• Last 2 months’ bank statements
• 12 months’ out-of-pocket expense report from your retail pharmacy
  • Please also include what your cash price or insurance copay would be for the medication(s) you are needing assistance with
• Last month’s pay stubs
• Social Security benefits statement (if applicable)

First-time applicants: Income documentation is not required.