MS One to One Patient Assistance Program: Lemtrada

Funded

About

The MS One to One Patient Assistance Program: Lemtrada provides eligible patients with the opportunity to receive Lemtrada at no cost. This program is designed for patients who meet specific eligibility criteria, including being US residents with limited or no prescription insurance. The MS One to One Patient Assistance Program aims to support those with financial needs and ensure they have access to necessary treatments, emphasizing the use of Lemtrada for their condition.

Insurance requirements: 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 may be able to receive medication free of charge

•HCP must fax completed LEMTRADA Service Form to 8555572478 to enroll patient in support services and LEMTRADA REMS

•Direct link to download form is not available; it must be downloaded from the LEMTRADA Resources page (check the box for LEMTRADA Services Form)

•If patients are approved, arrangements will be made for patients to receive medication at their prescriber's or HCP's office

•Patient must apply and be rejected by Medicaid before being accepted to program

•Please call MS One to One at 1–855–676–6326 to learn more about support services

Enrollment Forms

Enrollment Form