Ipsen Cares Co-Pay Assistance Program: Dysport

Funded

About

The Ipsen Cares Co-Pay Assistance Program: Dysport offers a valuable opportunity for patients seeking to manage their treatment expenses with Dysport. This program supports eligible patients by covering substantial copay costs, allowing them to pay as little as $0 out-of-pocket within specific limits. The Ipsen Cares Co-Pay Assistance Program: Dysport is especially beneficial for those with private insurance and provides specialized support for residents of Massachusetts and Rhode Island regarding the product's cost. With simple enrollment options and dedicated support, the Ipsen Cares Co-Pay Assistance Program: Dysport aims to relieve financial burdens for patients using Dysport.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

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: No

•Needs Based: No

•Activation Required: Yes

Program Details

•Eligible commercially insured patients may pay as little as $0 outofpocket up to a maximum annual limit

•Program resets every January 1st

•Patients residing in Massachusetts or Rhode Island can only receive assistance with the cost of Ipsen products but not the cost of related medical services (injection)

•Patient and HCP may enroll online, or submit completed enrollment form via fax to 8885252416

•For assistance or additional information, call 8664355677, 8:00 am to 8:00 pm ET, Monday Friday

Enrollment Forms

Enrollment Form