Ilumya Early Access Program

Funded

About

The Ilumya Early Access Program offers significant benefits by providing the drug Ilumya at no cost to eligible patients in the United States, Guam, Virgin Islands, or Puerto Rico. The program is designed to support patients who are 18 to 64 years old and have commercial insurance, enabling them to access Ilumya for up to two years or until they secure insurance coverage approval.

Insurance requirements: Commercially insured, Underinsured

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: No

•Activation Required: No

Program Details

•The Early Access Program provides ILUMYA at no charge to eligible patients for up to 2 years or until they receive insurance coverage approval, whichever occurs earlier

•Enrollment must be initiated by patient's HCP

•HCP can enroll patient online at https://www.ilumyasupport.com/ilumyasupportprovider/ or fax the completed form to 8778726575

•Requires the initial authorization(s) be submitted as early as possible, well in advance of the patient’s third dose; Failure to do so in a timely manner will result in the patient no longer being eligible for the program

•Call 8554458692 Monday through Friday, 8 AM to 8 PM ET, for assistance or additional information

Enrollment Forms

Enrollment Form