Cystadrops Patient Assistance Program

Funded

About

The Cystadrops Patient Assistance Program offers valuable support for individuals needing financial assistance with Cystadrops. This program is designed specifically for patients who may lack insurance and offers various benefits, including further financial assistance. The Cystadrops Patient Assistance Program is a dedicated initiative providing essential resources for qualifying patients to obtain their prescribed Cystadrops therapy.

Insurance requirements: Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Patients who lack insurance and meet certain financial requirements may be eligible for additional financial support from a patient assistance program

•HCP should complete and fax the CYSTADROPS treatment form to 8558132039 to initiate benefit verification and prior authorization support

•For eligibility requirements, restrictions, and limitations information, call 8669256212 MondayFriday 8am5pm CT

Enrollment Forms

Enrollment Form