Adcirca Co-pay Assistance Program
Funded
About
The Adcirca Co-pay Assistance Program provides eligible patients with significant financial support for their Adcirca prescriptions. With the Adcirca Co-pay Assistance Program, patients can reduce their out-of-pocket costs to as little as $0, ensuring better access to their essential medication.
Insurance requirements: Commercially insured
Enrollment Forms
Enrollment Form
Benefits
•$9600 annual maximum benefit
•12 maximum fills per year
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: No
•Needs Based: No
•Activation Required: No
Program Details
•Eligible commercially insured patients may pay as little as a $0 copay for each prescription of Adcirca up to the maximum monthly benefit of $800
•Card can be printed for immediate use following online enrollment & eligibility
•For assistance or additional information, call 8778648437
•For any questions regarding Change HealthCare online processing, please call the Help Desk at 18004334893
Enrollment Forms
Enrollment Form