Myfembree Copay Assistance Program

Funded

About

The Myfembree Copay Assistance Program offers eligible patients an affordable way to access the drug Myfembree, ensuring that those with commercial insurance can benefit by reducing their prescription costs to as low as $5 per month or $15 for a 90-day supply. The program emphasizes accessibility for residents within the U.S., Puerto Rico, and U.S. territories while providing up to $5,000 in annual support to make Myfembree treatment more attainable.

Insurance requirements: Commercially insured

As low as: $5 per mo

Enrollment Forms

Enrollment Form

Benefits

•$5000 annual maximum benefit

•12 maximum fills per year

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients will pay as little as $5 per monthly prescription or $15 if they received a 90day prescription

•Maximum of $5,000 per calendar year; after annual max is reached patient will be responsible for the remaining monthly outofpocket costs

•Program may not be redeemed more than once every 21 days

•For any questions, call 18336933627 MondayFriday 8am8pm ET

Enrollment Forms

Enrollment Form