Y-mAbs Connect Co-Pay Program: Danyelza

Funded

About

The Y-mAbs Connect Co-Pay Program: Danyelza offers eligible patients a significant financial benefit by reducing out-of-pocket costs for the drug Danyelza. By participating in the Y-mAbs Connect Co-Pay Program, patients can save up to $15,000 per enrollment period, with the possibility to pay as little as $0 for their infusion-related co-pays, making treatment more accessible for those who meet the program criteria.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$15000 annual maximum benefit

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 pay as little as $0 for outofpocket costs of DANYELZA

•Maximum benefit of $15,000 per enrollment period

•Each enrolled patient will be eligible to receive copay assistance for one enrollment period; 12 months from the date of enrollment

•Program benefit applies only to the copay for an infusion of DANYELZA, and not to any related procedure, service, or hospital stay

•Completed enrollment form can be faxed (18772096227), emailed (ymabsconnect@pharmacord.com), or mailed (PO Box 5490, Louisville, KY 40255)

•Explanation of Benefits (EOB) and claim forms must be submitted to YmAbs Connect for copay assistance

•For more information call 18333396227, Monday through Friday, 8AM to 8PM ET

Enrollment Forms

Enrollment Form