Apretude Savings Program

Funded

About

The Apretude Savings Program offers significant financial assistance for those prescribed Apretude. It is designed to reduce the cost of medication and associated administration expenses for eligible individuals. With the Apretude Savings Program, patients may benefit from low copays and substantial assistance with out-of-pocket costs, ensuring that the financial burden of healthcare is minimized.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$7850 annual maximum benefit

•13 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: Yes

Program Details

•Eligible consumers may pay as little as $0 copay on each prescription fill

•Eligible consumers may also receive assistance with the consumer's outofpocket costs associated with the administration of Apretude of up to $50 per treatment (maximum of 13 eligible dates of service in 12month period) costs

•Maximum annual limit of $7,850 (includes both the consumer's outofpocket medication costs as well as the injection administration costs)

•All Apretude claims must be submitted within 180 days of insurance payment to receive payment from the program; an Explanation of Benefits from the consumer's commercial insurance plan detailing their outofpocket costs for APRETUDE must be included

•Benefits may apply to eligible outofpocket costs incurred by the patient for Apretude within 180 days prior to the date an eligible patient is enrolled, subject to annual program maximum

•Call the Apretude Savings Program at 8008093442, Monday Friday, 8AM 8PM (ET) with any questions regarding the program, eligibility or benefits

Enrollment Forms

Enrollment Form