Adbry Copay Program - Covered benefit

Coverage RequiredFunded

About

The Adbry Copay Program - Covered benefit provides significant financial assistance for eligible patients prescribed Adbry. This program allows commercially insured patients to potentially pay as little as $0 per fill, with an annual maximum benefit of $13,000. By covering private insurance co-pays and offering substantial savings, the Adbry Copay Program makes accessing Adbry more affordable for patients with eligible insurance plans who need it for FDA-approved indications.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$13000 annual maximum benefit

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: Yes

•Needs Based: No

•Activation Required: Yes

Program Details

•Eligible commercially insured patients may pay as little as $0 copay per fill

•Annual maximum benefit $13,000 per eligible patient

•Amount of reimbursement may vary, including based on an eligible patient’s insurance coverage

•Patients remain responsible for any remaining costs for the product after application of Program reimbursement or reaching the annual maximum limitation

Enrollment Forms

Enrollment Form