ADvantage Ig Patient Support Program: Asceniv - Covered benefit

Coverage RequiredFunded

About

The ADvantage Ig Patient Support Program: Asceniv - Covered benefit provides essential support for patients using the drug Asceniv. This program is designed to alleviate financial burdens by covering up to $15,000 of out-of-pocket costs per year for eligible patients who are residents of the US and have private commercial insurance. The ADvantage Ig Patient Support Program ensures that patients can effectively manage their treatment expenses with features like deductible, copay, and coinsurance assistance specifically for Asceniv.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$15000 annual maximum benefit

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: Yes

•Needs Based: No

•Activation Required: No

Program Details

•Program covers up to $15,000 of outofpocket costs per calendar year for eligible patients

•Proof required for receiving payment for outofpocket drug costs must be a valid Explanation of Benefits(EOB) or specialty pharmacy invoice, which must be submitted within 120 days after each treatment

•Prescriber must fill out and fax the enrollment form back to ADvantage Ig Patient Support Program at (833) 2160441

•Call (833) 2362246 Monday through Friday, 9:00 am – 6:00 pm Eastern Time for more information

Enrollment Forms

Enrollment Form