Kineret on Track Patient Assistance Program

Funded

About

The Kineret on Track Patient Assistance Program offers eligible patients the opportunity to receive the drug Kineret free of charge for one year. By participating in the Kineret on Track Patient Assistance Program, patients can ease their financial burden while obtaining essential medication. The program ensures access to Kineret for patients under the care of a licensed healthcare provider, making it easier to manage their health without the stress of medication costs.

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 can receive medication free for one year

•Patients must fax completed form to 18665497219

•Only faxed prescriptions received directly from the physician's office along with a physical fax cover and valid fax banner can be accepted

•Patients must also attach proof of income (e.g. Tax Return, W2, bank statements, etc); if patient does not have proof of income, patient may complete a notarized income statement or attestation statement form furnished on request by contacting the Kineret On TRACK Support Program, 18665470644

•If patient is insured, must provide copies of the front and back of current insurance and prescription cards

•Patients could be approved on the same day of receiving completed form

•Medication will be shipped to eligible patients

•For more information, please call 8665470644

Enrollment Forms

Enrollment Form