Gomekli Copay Program
Funded
About
The Commercial Copay Program (the “Program”) provides reimbursement for eligible, commercially insured
patients’ cost-sharing obligations (including deductibles, copayments, coinsurance, or amounts in excess of
maximum benefit limits) for GOMEKLI up to an annual maximum limitation, as may be adjusted from time
to time at the sole discretion of the Program. The amount of reimbursement may vary, including based on
an eligible patient’s insurance coverage
Insurance requirements: Commercially insured
Savings Card
Pay as low as
Get Savings Card$0/ fill
Benefits
•15 maximum fills per year
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: No
•Coverage Required: No
•Needs Based: No
•Activation Required: No
Program Details
•Patient must not be insured by any commercial payer that prohibits the provision of assistance under a manufacturer copay program. To the extent a payer imposes limits or requirements on the provision of such assistance, the patient may be eligible for the Program to such limits or requirements
•Patient may use Copay Card up to 15 times per calendar year
Savings Card
Pay as low as
Get Savings Card$0/ fill