KevzaraConnect Patient Assistance Program (RA/pJIA)
Funded
About
The KevzaraConnect Patient Assistance Program (RA/pJIA) offers significant benefits for eligible patients who need the drug product Kevzara. This program is designed to help patients who are uninsured or functionally uninsured receive Kevzara at no cost. By supporting patients with a valid prescription treated by licensed U.S. healthcare providers, KevzaraConnect ensures access to necessary medication for those in need, including special considerations based on family size and other circumstances.
Insurance requirements: Medicare / Medicaid, Underinsured, Uninsured
Enrollment Forms
Enrollment Form
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: Yes
•Activation Required: No
Program Details
•Eligible patients may be able to receive medication free of charge
•HCP should fax completed application form to 18445388960 or upload page 1 to the Patient Support Portal (www.patientsupportnow.org and enter code 8445388960)
•For assistance or additional information, please call 8445389272
Enrollment Forms
Enrollment Form