Pfizer Oncology Together Patient Assistance Program

Funded

About

The Pfizer Oncology Together Patient Assistance Program offers comprehensive support for patients prescribed drugs like Besponsa, Mylotarg, Daurismo, Ibrance, Talzenna, Bosulif, Braftovi, Mektovi, Xalkori, Vizimpro, Mektovi, Talzenna, Tuksya, Lorbrena, and Inlyta. By enrolling in the Pfizer Oncology Together Patient Assistance Program, eligible patients can access necessary medications, potentially for free, and receive assistance with Medicaid applications and financial guidance, focusing on making healthcare more accessible to uninsured or underinsured individuals.

Insurance requirements: Medicare / Medicaid, Uninsured

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: Yes

•Activation Required: No

Program Details

•Program can help identify resources for patients who do not have any form of healthcare coverage

•Program will check patient eligibility for Medicaid; If eligible, can help patients understand how to apply and provide assistance throughout the process

•Eligible patients may receive up to a 90day supply of Pfizer medications for free while applying for Medicaid

•If patients do not qualify for Medicaid, they may be able to get a 1year supply of their medication for free through the Pfizer Oncology Together Patient Assistance Program

•Uninsured patients may receive free medication for up to 1 calendar year, while underinsured patients are enrolled through the end of the calendar year

•Patient and HCP must complete enrollment form and fax to 18777366506 OR

•Upload online at patientsupportnow.org, and enter code 8777366506 OR

•Mail the application to Pfizer Oncology Together PO Box 220366, Charlotte, NC, 282220366

•HCP can also use the Pfizer Oncology Together Provider Portal to get financial and billing assistance , or upload documentation (Provider Portal located here: https://www.pfizeroncologytogetherportal.com/)

•For questions, please call 18777445675, Monday–Friday, 8 am–8 pm ET

•FOR MEDICARE PART D/MEDICARE ADVANTAGE PATIENTS ONLY:

•Patients enrolling must certify that they have enrolled in the Medicare Prescription Payment Plan (allows patients to pay their prescription drug costs in capped monthly payments instead of all at once), AND

•Have NOT paid their $2,000 total prescription costs for the year that the patients is requesting assistance (my outofpocket maximum has not been met), AND

•Cannot afford their medication

Enrollment Forms

Enrollment Form