Briumvi Copay Assistance Program - Covered benefit

Coverage RequiredFunded

About

The Briumvi Copay Assistance Program - Covered benefit offers significant financial assistance for patients prescribed Briumvi, allowing eligible individuals to potentially pay as little as $0 per treatment, with coverage up to $20,000 annually. This program aims to offer support for patients with commercial prescription insurance, ensuring they receive the necessary financial aid for both medication and administration costs. With a simple automatic renewal process, the Briumvi Copay Assistance Program ensures ongoing support for those who qualify.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$20000 annual maximum benefit

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: Yes

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may pay as little as $0 copay per BRIUMVI treatment up to the annual maximum $20,000

•The product benefit is only valid for patients who have commercial prescription drug insurance coverage

•Claims must be submitted within 365 days from the EOB or dispense date unless otherwise indicated

Enrollment Forms

Enrollment Form