Loqtorzi Solutions Patient Assistance Program

Funded

About

The Loqtorzi Solutions Patient Assistance Program offers significant benefits to eligible patients needing the drug Loqtorzi. This program provides uninsured, functionally underinsured, or traditional Medicare FFS patients who face financial hardship with an opportunity to receive their medication at no cost. The Loqtorzi Solutions Patient Assistance Program is committed to ensuring patients under the care of a U.S. licensed provider can access Loqtorzi, provided they meet specific financial and eligibility criteria.

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 uninsured, functionally underinsured, or traditional Medicare FFS patients that demonstrate financial hardship may be able to receive their medication for free

•HCP can apply online for patient at https://login.coherussolutions.com/ or download and fax completed form to 8772266370

•Call 18444833692 Monday to Friday, 8 am to 8 pm ET, for assistance or additional information

Enrollment Forms

Enrollment Form