Kimmtrak Connect Co-Pay Program

Funded
About
The Kimmtrak Connect Co-Pay Program provides financial assistance to eligible patients for their Kimmtrak prescriptions. With the Kimmtrak Connect Co-Pay Program, patients may pay as little as $0 for their co-pay or coinsurance costs, though it only covers Kimmtrak doses and not other treatment costs. This program is a beneficial option for patients with commercial insurance, ensuring affordable access to their necessary medication.
Insurance requirements: Commercially insured, Underinsured
Enrollment Forms
Enrollment Form
Benefits
•$7500 annual maximum benefit
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
•Eligible patients may pay as little as $0
•Program benefits are limited to the copay or coinsurance costs for doses of KIMMTRAK only; other treatment costs such as office visits or administration charges are not covered
•Complete enrollment form online or fax to 8669813072 or by email PatientSupport@kimmtrakconnect.com
•Patient or healthcare provider must submit an Explanation of Benefits (EOB) from the patient’s insurance within 180 days from the date of the EOB. The EOB must include the name of the patient receiving the copay/coinsurance benefit, name of the insurer and plan, and that KIMMTRAK was the product administered
•For more information patients must call 8447752273, MondayFriday, 9 AM7 PM (EST)