Nerlynx Co-pay Card

Funded

About

The Nerlynx Co-pay Card program offers significant financial assistance to patients prescribed Nerlynx. Eligible patients with commercial or private insurance can benefit from reduced co-pays, potentially paying as little as $10 per prescription fill. This program is designed to ease the financial burden of accessing Nerlynx by streamlining enrollment through specialty pharmacies, clinics, or online registration. The Nerlynx Co-pay Card is an excellent opportunity for eligible patients to afford their prescribed medication without the full out-of-pocket costs.

Insurance requirements: Commercially insured

As low as: $10 per fill

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: Yes

Program Details

•Commercially insured patient may pay as little as $10 at the time prescription is being filled

•Patients can be enrolled through their specialty pharmacy or clinic or sign up online themselves

•Card can be printed for immediate use following online eligibility questions and registration

•Patients enrolled in the NERLYNX Patient Assistance Program are not eligible to receive this offer

•Limited to one per person

•Pharmacies: Process a Coordination of Benefits claim using the patient’s prescription insurance for the PRIMARY claim. Submit a SECONDARY claim using BIN: 610020

•For pharmacy processing questions, call 18558477423 (Monday – Friday 24 hours, Saturday 8 AM – 7 PM EST, and Sunday 9 AM – 5 PM EST)

Enrollment Forms

Enrollment Form