Factor Access Program: Alprolix

Funded

About

The Factor Access Program: Alprolix offers significant benefits for patients needing Alprolix. This program supports patients facing insurance gaps or lacking coverage by providing Alprolix at no cost. The Factor Access Program: Alprolix ensures that patients can access necessary treatments in a timely manner, making it an invaluable resource for eligible individuals.

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

•Patients experiencing gaps and caps with insurance or are completely uninnsured are eligible to receive drug free of charge

•Patients can enroll by calling 18556925776 or by downloading the form on the site

•Completed forms should be faxed to 18553987634

•A MyALPROLIX Coordinator will contact the patient within 2 business days to provide information about their eligibility

•Program enrollment is for 1 year; program is renewable as long as the patient's situation remains the same

Enrollment Forms

Enrollment Form