Fensolvi TotalSolutions Copay Assistance

Funded
About
The Fensolvi TotalSolutions Copay Assistance program offers financial support for patients prescribed Fensolvi, allowing eligible commercially insured individuals to pay as little as $5 per prescription with a maximum benefit of $10,000 annually. This comprehensive program is a great resource for reducing out-of-pocket costs for Fensolvi, ensuring accessible treatment for those with private insurance coverage.
Insurance requirements: Commercially insured
As low as: $5 per fill
Enrollment Forms
Enrollment Form
Benefits
•$10000 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 $5 per prescription
•Maximum benefit of $10,000 per calendar year
•Restrictions or limits may apply
•Completed enrollment form can be faxed to: 14125203442 or emailed to: FensolviTotalSolutionsCopay@connectiverx.com
•Claims must be submitted to the Program within 180 days of the date of the Explanation of Benefits (EOB) from patient's primary insurance company
•For more information patients must call 1888FENSOLVI (18883367658)