Iluvien CoPay Program

Funded

About

The Iluvien CoPay Program offers significant financial relief for patients requiring the drug Iluvien. Designed to help patients with private insurance manage out-of-pocket expenses, this program reduces co-pays for those whose costs exceed $25. Though not available to those on state or federally funded programs, Iluvien CoPay Program ensures accessible medication with straightforward enrollment via AccessPlus, while requiring proof of household income for program approval.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

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

•Copay assistance is available for eligible patients with outofpocket costs that exceed $25

•Household income and number in household is required information for program approval; proof of income may be requested for auditing purposes

•Once approved, patient and physician will receive a welcome letter

•CoPay Program does not apply to the patient cost sharing for the injection procedure, diagnostic tests or other costs associated with the administration of ILUVIEN

•Enrollment form can be filled out and fax to AccessPlus at 18445017161

Enrollment Forms

Enrollment Form