Offer subject to change or discontinuance without notice. The Early Access Program provides ILUMYA ® at no charge to patients for up to 2 years or until they receive insurance coverage approval, whichever occurs earlier. These offers are not health insurance and are only valid for patients in the United States, Guam, Virgin Islands, or Puerto Rico. These offers are not valid under Medicare, Medicaid, VA, DOD, TRICARE, or any other federal or state program, for cash-paying patients, where the product is not covered by patient’s commercial insurance, or where a plan reimburses patient for the entire cost of prescription drug. If you live in Massachusetts or California, the Copay Card expires on the earlier of December 31, 2020, or date an AB-rated generic equivalent is available. These offers are void where prohibited or restricted by law. These offers may be terminated, rescinded, revoked, or amended by Sun Pharmaceutical Industries, Inc. These offers for Copay Card and Early Access Program expire in 12 months and 24 months, respectively, based on program initiation date.
Eligibility for the Early Access Program is validated through continuous coverage checks and may change if the patient no longer meets the current program eligibility requirements. ILUMYA SUPPORT ® will work with the patient’s provider to submit PAs, appeals, and other required information. Patients may receive ILUMYA ® without charge for up to 2 years or until they obtain coverage. Failure to submit a medical and/or pharmacy appeal prior to the patient’s fourth dose will result in the patient no longer being able to participate in the Early Access Program and no longer receiving ILUMYA ® at no cost. Patient continuation in the Early Access Program is contingent on provider submission of a medical and/or pharmacy appeal before a patient’s fourth dose of ILUMYA ®. Failure to submit a medical and/or pharmacy PA prior to the patient’s third dose will result in the patient no longer being able to participate in the Early Access Program and no longer receiving ILUMYA ® at no cost. Patient continuation in the Early Access Program is contingent on provider submission of a medical and/or pharmacy PA before a patient’s third dose of ILUMYA ®. ILUMYA SUPPORT ® will work with the patient’s provider to submit a medical and/or pharmacy PA to the patient’s insurance plan before the patient’s third dose.
Rinvoq copay card free#
EARLY ACCESS PROGRAMĮligible commercially insured patients ages 18 years and older who meet program eligibility requirements and have commercial insurance are automatically enrolled in the Early Access Program without the need for an initial prior authorization (PA) and can receive ILUMYA ® free of charge for up to 2 years while appealing their denied coverage. It is prohibited for any person to sell, purchase, or trade offer to sell, purchase, or trade or counterfeit this Copay Card. This offer is not valid with any other program, discount, incentive, or similar offer involving ILUMYA ®. One digital card per patient, not transferable, and cannot be combined with any other offer.īy accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Copay Card. This offer is valid only for patients who meet the program eligibility requirements, have commercial insurance that covers ILUMYA ®, and have a valid prescription. After the program maximum, patients will be responsible for the difference. By providing the information and selecting the Submit button, you indicate that you read, understand, and agree to these terms.ILUMYA SUPPORT® PATIENT ACCESS PROGRAMS AND SERVICESĮligible commercially insured patients 18 years or older may pay as little as $5 per dose for an ILUMYA ® prescription, subject to a $16,000 maximum annual program benefit. Our Privacy Policy governs the use of the information you provide.
Rinvoq copay card registration#
You can ask to cancel your registration by calling 877-CarePath (87) Monday-Friday 8:00 am - 8:00 pm ET or by completing the form below and checking opt out in the Safe Returns ® Program Options. The information you provide will be used by Janssen Biotech, Inc., our affiliates, and our service providers, for your enrollment and participation in the SIMPONI ® Safe Returns ® program, and for any program options you may select. Sign up and stay up to date about SIMPONI ®.
0 kommentar(er)
