Kisqali Bridge Program

Funded

About

The Kisqali Bridge Program offers significant benefits for patients by providing up to 5 free treatment cycles of Kisqali while pursuing health plan coverage. Designed for those who have private insurance and a valid prescription for Kisqali, the program ensures access to necessary medication even while awaiting insurance approval, making it a valuable resource for eligible patients.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients can receive up to 5 free treatment cycles of Kisqali while their health plan coverage is pursued

•Privately insured patients waiting for their coverage to take effect for KISQALI and/or FEMARA (including generic letrozole) may be eligible for an additional supply of KISQALI that could continue for up to 5 treatment cycles

•Once the form is completely filled out, fax form to 8004143518

•For questions or concerns, call 18664338000 MF 8AM 8PM EST, excluding holidays

Enrollment Forms

Enrollment Form