Myfembree Copay Assistance Program - Covered benefit

Coverage RequiredFunded

About

The Myfembree Copay Assistance Program - Covered benefit is designed to help eligible patients afford their Myfembree prescriptions. With this program, patients with commercial insurance can pay as little as $5 for a monthly prescription or $15 for a 90-day prescription, with an annual savings limit of $5,000. The Myfembree Copay Assistance Program is an excellent option for those seeking cost-effective solutions for their healthcare needs while utilizing the Myfembree drug product.

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: Yes

•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

Enrollment Forms

Enrollment Form