Kimyrsa Patient Assistance Program
Funded
About
The Kimyrsa Patient Assistance Program offers eligible uninsured patients the opportunity to receive the drug Kimyrsa at no cost. This beneficial program requires no medical or prescription insurance coverage for participants and ensures accessibility by involving both healthcare professionals and patients in the application process.
Insurance requirements: Underinsured, Uninsured
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: Yes
•Activation Required: No
Program Details
•Eligible uninsured patients may be able to receive KIMYRSA at no cost
•HCP and patient must sign and complete form; fax to 18558862482
•Call 18445469772, MondayFriday, 8am8pm ET, for more information or assistance
Enrollment Forms
Enrollment Form