CSL Behring Patient Assistance Program: All Other Drugs

Not Funded
About
The CSL Behring Patient Assistance Program: All Other Drugs offers crucial support to patients needing access to medications like Corifact, Humate P, Idelvion, Afstyla, and RiaSTAP. This program is designed to help those with limited insurance coverage by providing up to a 3-month supply of these products. Through the CSL Behring Patient Assistance Program, eligible patients can benefit from quick access to necessary medications, streamlining the process with a direct shipping option to their healthcare providers.
Insurance requirements: Underinsured, Uninsured
Enrollment Forms
Enrollment Form
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: Yes
•Activation Required: No
Program Details
•Patient must call program, and if preliminarily determined to be eligible, the CSL Behring Department of Reimbursement Services will email or fax a Program Qualification Form to be completed by both the patient and his or her physician
•Qualified patients may receive up to a 3month supply of a CSL Behring product
•At the end of 3 months, the patient’s eligibility is reevaluated for continued participation in the program if needed
•Enrollment in the program requires the following information:
•1. A completed Patient Assistance Qualification Form, including income documentation (W2, pay stub, notarized letter, etc.)
•2. The brand name prescription for medication
•3. A letter from the physician with the patient's name, complete mailing address, date of birth, social security number, diagnosis, insurance status, and insurance synopsis (reason for need and description of other attempts made to access alternate coverage)
•Unlike other programs that require routine submission of forms, the CSL Behring Patient Assistance Program only requires completion of these forms when the need arises
•For approved patients, medication is shipped overnight to doctor's office, specialty pharmacy, or hospital
•Length of time patients are approved for program varies based on circumstances
•Call AFSTYLA Connect at 18006764266 to speak with a Case Manager Monday through Friday, 8 am to 8 pm ET