Fycompa Instant Savings Card - Non-covered benefit

Funded

About

The Fycompa Instant Savings Card - Non-covered benefit offers significant savings on the Fycompa drug for eligible patients. This program allows cash patients to potentially save $60 on each prescription, with an annual saving of up to $720. While the Fycompa Instant Savings Card provides financial relief, it is important to note the specific eligibility criteria. Emphasizing accessibility, this program helps reduce pharmaceutical costs associated with Fycompa, targeting patients not covered by federal or state healthcare programs.

Insurance requirements: Commercially insured, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Benefits

•$720 annual maximum benefit

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 cash patients may be able to save $60 per prescription with a maximum of $720 per year

•Commercially insured and cash patients could have additional financial responsibility for any amounts over maximum benefit

Enrollment Forms

Enrollment Form

Other Programs

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Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Fycompa Instant Savings Card - Covered benefit

Coverage Required

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $250012/year*

Pay as low as

$5/ mo

Other Tools for Fycompa

Get prior authorization forms

Get patient education materials