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
How to get started
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Medication Name | Program Name | Program Type | Program Phone | Website |
---|---|---|---|---|
FINGOLIMOD | PATIENT ACCESS NETWORK FOUNDATION | FOUNDATION | 866-316-7263 | https://www.panfoundation.org |
FINGOLIMOD | PATIENT ADVOCATE FOUNDATION | FOUNDATION | 866-512-3861 | https://www.patientadvocate.org/ |
FINGOLIMOD | QUALLENT FINGOLIMOD COPAY ASSIST | MANUFACTURER | 800-987-7839 | |
FIRAZYR | FIRAZYR COPAY ASSIST | MANUFACTURER | 866-888-0660 | |
FLEBOGAMMA | ASSISTRX:THE ASSISTANCE FUND FOUNDATION | FOUNDATION | 855-845-3663 | https://tafcares.org |
FLOLAN | ASSISTRX:THE ASSISTANCE FUND FOUNDATION | FOUNDATION | 855-845-3663 | https://tafcares.org |
FLOLAN | GOOD DAYS FKA CHRONIC DISEASE FOUNDATION | FOUNDATION | 877-968-7233 | https://mygooddays.org |
FLOLAN | HEALTHWELL FOUNDATION | FOUNDATION | 800-675-8416 | https://www.healthwellfoundation.org |
FLOLAN | PATIENT ACCESS NETWORK FOUNDATION | FOUNDATION | 866-316-7263 | https://www.panfoundation.org |
FLOLAN | PATIENT ADVOCATE FOUNDATION | FOUNDATION | 866-512-3861 | https://www.patientadvocate.org/ |