G1 Commercial Copay Program: Cosela

Funded

About

The G1 Commercial Copay Program: Cosela offers financial assistance to patients prescribed with Cosela, ensuring affordability by covering the out-of-pocket costs of the drug. This program is specifically for patients with commercial insurance, making Cosela more accessible to qualifying individuals.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may be able to receive financial assistance for COSELA

•The G1 Commercial Copay Program covers ONLY the outofpocket cost of COSELA and does not cover any administrative or office visit costs

•HCP or office staff can enroll patient online or download the enrollment form from https://www.cosela.com/pdf/G1_to_One_Enrollment_Form.pdf and fax to 8333294121 or email to Enroll@G1toOne.com

•Call 8334186663 for assistance or additional information

Enrollment Forms

Enrollment Form