BioLineRx Connect Patient Assistance Program: Aphexda
Funded
About
The BioLineRx Connect Patient Assistance Program: Aphexda offers a valuable opportunity for patients in the United States to receive the drug Aphexda at no cost if they meet specific criteria. This program is designed to help uninsured or underinsured patients with limited or no prescription insurance. By leveraging the BioLineRx Connect Patient Assistance Program: Aphexda, eligible patients can access necessary medications through a streamlined enrollment process that includes support from licensed U.S. 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
•Eligible uninsured or underinsured patients may be able to receive medication free of charge
•HCP should fax completed enrollment form to 8772562430
•Call 8665246546, Monday – Friday 9:00 AM – 5:00 PM ET, for assistance or additional information
Enrollment Forms
Enrollment Form