Byooviz Drug Copay Program

Funded

About

The Byooviz Drug Copay Program offers eligible commercially insured patients in the United States an opportunity to reduce their copay costs for the drug Byooviz. This program is designed to make accessing Byooviz more affordable by covering the cost of the medication itself, while other associated treatment costs remain uncovered. By utilizing the Byooviz Drug Copay Program, patients benefit from a potential decrease in out-of-pocket expenses, contingent upon proper enrollment and adherence to eligibility requirements.

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

•Eligible commercially insured patients may be eligible to pay lower copay costs under this program

•The BYOOVIZ Drug Copay Program covers only the cost of the drug and does not cover other services and fees associated with treatment, such as office visits, administration costs or additional fees

•Maximum benefit amount may vary or change depending on patient's insurance coverage; benefit resets every January 1

•HCP must enroll patient in Biogen Biosimilar Support Services prior to applying for copay assistance

•Completed BBSS enrollment form can be faxed to 2406968830; HCP can also enroll patient online at the HCP Portal: https://biogenbiosimilarsupportservices.com/

•After HCP has enrolled patient in the Biogen Biosimilar Support Services, they must also fax the completed Copay Screening Form to 2406968830. Form can be downloaded here: https://www.biogencdn.com/us/biosimilars/byo/2023/byoovizcopayform.pdf)

•The patient’s insurance will be billed first and must pay before copay assistance will be applicable

•Call 8774228360, Monday through Friday, 8:30 am – 8:00 pm ET, for assistance or additional information

•** The Drug Copay Program and Administration Copay Program are different programs with unique eligibility for each; patients must enroll separately as needed

Enrollment Forms

Enrollment Form