Factor Access Program: Eloctate

Funded

About

The Factor Access Program: Eloctate provides vital assistance by offering Eloctate to eligible patients. This program ensures that uninsured individuals or those facing insurance challenges can access this essential medication free of charge. The Factor Access Program: Eloctate is a significant resource for patients with valid prescriptions who are under US-based care.

Insurance requirements: Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Patients who are uninsured, have no insurance coverage for their prescribed product, have reached their insurance cap, or have a lapse in insurance coverage may be eligible to receive Elocate free of charge

•Patients can enroll by calling 18556935628 or by downloading the form on the site

•Completed forms should be faxed to 18553987634

•A Factor Access Coordinator will contact the patient within 2 business days to provide information about their eligibility

•Program enrollment is for 1 year; program is renewable as far as the details remain the same

Enrollment Forms

Enrollment Form