Kimyrsa Copay Savings Program

Funded

About

The Kimyrsa Copay Savings Program is designed to provide financial assistance to eligible patients using the drug Kimyrsa. With this program, commercially insured patients can benefit from reduced costs of their medication, paying as little as $50 per treatment. The program covers maximum benefits of up to $1,200 per treatment with no limit on the number of treatments, making access to Kimyrsa more affordable and accessible.

Insurance requirements: Commercially insured

As low as: $50 per fill

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

•Eligible commercially insured patients may pay as little $50 per treatment

•Maximum benefit of $1,200 per treatment, no limit of treatments

•Requires treatment in outpatient setting

•Patient and HCP must complete form and fax to 8558862482

•Patient must provide email address to receive virtual debit card information for copay payments

•Call 8445469772, Monday through Friday, 8am – 8pm ET, for assistance or additional information

Enrollment Forms

Enrollment Form