PharmaEssentia Bridge Program: Besremi

Funded

About

The PharmaEssentia Bridge Program: Besremi offers an invaluable support service for patients using the drug Besremi. This program assists those facing insurance delays or gaps by providing temporary 2-week supplies for up to 2 months, ensuring uninterrupted treatment. To be eligible, patients must reside in the U.S. or its territories and have commercial insurance. The PharmaEssentia Bridge Program: Besremi underscores its commitment to patient care by facilitating access to critical medication during challenging times.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Patients experiencing insurance delays or gaps in coverage may be eligible to receive temporary 2week supplies of BESREMi for up to 2 months

•HCP must complete, sign and date, then fax completed form to 8007005065

•Patient must have a valid prescription from a US physician for BESREMi

•For assistance, call 18007005053 MondayFriday, 8am8pm ET

Enrollment Forms

Enrollment Form