Loqtorzi Solutions Co-Pay Savings Card
Funded
About
The Loqtorzi Solutions Co-Pay Savings Card provides eligible patients with an opportunity to significantly reduce their out-of-pocket costs for the Loqtorzi medication. The program is designed to assist commercially insured patients by offering savings on each dose of Loqtorzi, potentially as low as $0 out-of-pocket, with a maximum annual benefit of $30,000.
Insurance requirements: Commercially insured
Enrollment Forms
Enrollment Form
Benefits
•$30000 annual maximum benefit
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 be able to pay as little as $0 out of pocket for each dose of Loqtorzi
•Maximum benefit of $30,000 per calendar year
•Program benefits reset every January 1. Reenrollment in the program is required at regular intervals
•To receive copay assistance for drug copay costs, the provider, patient, or caregiver must enroll eligible individual within 180 days after the date of service for which the subsidy is sought
•Participating patients, pharmacies, physician offices and hospitals may use Coherus’ patient services web portal or fax completed enrollment forms to 8772266370
•Call 8444833692, Monday–Friday 8 am to 8 pm ET, for assistance or additional information
Enrollment Forms
Enrollment Form