Nerlynx Patient Assistance Program

Funded

About

The Nerlynx Patient Assistance Program is an excellent opportunity for uninsured patients to receive the drug Nerlynx at no cost. By participating in the Nerlynx Patient Assistance Program, eligible patients who meet income guidelines and reside in the United States can access this valuable medication free of charge, ensuring necessary treatment without financial burden.

Insurance requirements: 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

•NERLYNX is provided free to patients who are uninsured and meet certain financial qualifications

•Patient must be uninsured or not have coverage for NERLYNX and not be eligible for other public health insurance programs

•HCP and patient must fax the completed Enrollment Form and all supporting documents to Puma Patient Lynx at 8442765153

•For assistance or additional information, call 8558165421, Monday to Friday, 9 AM to 8 PM ET

Enrollment Forms

Enrollment Form

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