Adcirca Co-pay Assistance Program - Covered benefit

Coverage RequiredFunded

About

The Adcirca Co-pay Assistance Program - Covered benefit is designed to provide financial relief to eligible patients by significantly reducing their out-of-pocket expenses for Adcirca prescriptions. By participating in the Adcirca Co-pay Assistance Program, qualified patients with commercial insurance can pay as little as $0 per prescription, with a maximum monthly benefit of $800. This program is a valuable resource for those prescribed Adcirca for FDA-approved indications, offering substantial savings and support.

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: Yes

•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

Enrollment Forms

Enrollment Form