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
Other Programs
Myfembree Copay Assistance Program - Covered benefit
Coverage Required
Commercially Insured
Max Saving: $5000/year*
12 prescription fills per year*
Pay as low as
$5/ mo
Myfembree Copay Assistance Program - Non-covered benefit
Commercially Insured
Max Saving: $5000/year*
12 prescription fills per year*
Pay as low as
$5/ mo