Based on program guidelines, copay assistance may not be available to all patients. To determine eligibility, please refer to the program's website.1
Please review the criteria below for general requirements to qualify for manufacturer copay assistance:
- Have a prescription for a medication approved by the FDA for a specific use.
- Must be 18 years or older, or have a caregiver or authorized person handling copay assistance.
- In most cases, patients are required to have commercial (private or non-government insurance), such as those offered through state and federal health exchanges.2
- Cannot be enrolled in government-funded health insurance programs like Medicare or Medicaid, VA, DoD, TRICARE as commercial insurance does not include these programs.3
- Must reside and receive treatment in the United States or U.S. Territories.4
- 1Copay assistance estimates are subject to change. Please contact the copay assistance provider directly to confirm estimates provided and the balance of assistance remaining.
- 2Commercial insurance includes plans received from your employer or plans from the Health Insurance Marketplace.
- 3There are some exceptions.
- 4Please note that patients residing in California (CA) or Massachusetts (MA) and using a branded medication for which a generic alternative is available cannot receive aid for the same expenses covered by the program.
Types of copay assistance
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药品名称 | Program Name | Program Type | Program Phone | Website |
---|---|---|---|---|
CYRAMZA | CYRAMZA COPAY ASSIST | 生产商 | 866-472-8663 | https://oncologysupport.lilly.com/ |
DALFAMPRIDINE ER | ASSISTRX:THE ASSISTANCE FUND FOUNDATION | FOUNDATION | 855-845-3663 | https://tafcares.org |
DALFAMPRIDINE ER | HEALTHWELL 基金会 | FOUNDATION | 800-675-8416 | https://www.healthwellfoundation.org |
DALFAMPRIDINE ER | PATIENT ACCESS NETWORK 基金会 | FOUNDATION | 866-316-7263 | https://www.panfoundation.org |
DALFAMPRIDINE ER | 患者权益基金会 | FOUNDATION | 866-512-3861 | https://www.patientadvocate.org/ |
DAURISMO | DAURISMO COPAY ASSIST | 生产商 | 877-744-5675 | |
DAURISMO | HEALTHWELL 基金会 | FOUNDATION | 800-675-8416 | https://www.healthwellfoundation.org |
DAXXIFY | DAXXIFY COPAY ASSIST | 生产商 | 855-367-3294 | https://hcp.daxxifycervicaldystonia.com/access-daxxify |
DEFERASIROX | DEFERASIROX COPAY ASSIST | 生产商 | 844-248-7949 | https://www.tevausa.com/our-products/tevagenerics/deferasirox-oral-granules-copay-card/ |
DEFERASIROX ORAL GRANULES | DEFERASIROX ORAL COPAY ASSIST | 生产商 | 855-564-6963 | https://mprsetrial.mckesson.com/8005/eligible.html |